The current system of financing the domestic health care system is unsustainable in the long term, according to Zdeněk Kabátek, director of the General Health Insurance Company (VZP). Rising costs are exceeding the revenues of health insurance companies and their financial reserves are not inexhaustible. It is therefore necessary to find the courage to make fundamental changes, which include, above all, making the whole system more efficient. Increasing the financial participation of patients or introducing commercial supplementary insurance may also be considered. Kabátek said this today in Olomouc at the international symposium of the AGEL group on modern trends in cardiovascular treatment.
Revenues of the VZP basic health insurance fund are expected to rise by 7.1 percent to CZK 297 billion next year from CZK 277.3 billion this year, and expenses by 9.3 percent from CZK 277.3 billion to nearly CZK 306 billion, of which the cost of health services will rise by 9.5 percent to CZK 294 billion. The deficit between revenues and expenditures is thus CZK 9 billion. Kabátek pointed out that while until 2018 the VZP’s revenues exceeded expenditures, in the pandemic years of 2020 and 2021 the tables have turned.
According to Kabátek, the cost of health services has been increasing in the last two years, when the coronavirus pandemic has subsided, mainly due to the application of expensive technologies and drugs as well as internal inefficiencies in the system. The Union of Health Insurance Companies of the Czech Republic, which brings together six smaller insurance companies, recently warned that the cost of the public health insurance system could be up to CZK 12 billion higher next year than the health ministry plans in its draft reimbursement decree. The difference between income and expenditure could be as much as CZK 20 billion.
“The current model of financing (health care) without fundamental changes is unsustainable in the long term. If I compare it to a steamship, we are still sailing, we have enough coal in the hold and we can probably move in some direction for a long time. But if we want to be able to go faster, manoeuvre and visit more destinations, we need to change something. That change has to be legislative first and foremost, because without that, we won’t move,” said Kabatek, who said we can immediately start improving the efficiency of the healthcare sector.
Kabátek sees changing the long-distorted reimbursement system as key. “It (the system) is heading towards not paying for curing a patient, but for treating a patient. I don’t pay for the outcome, I pay for the production. This is simply nonsense,” Kabátek pointed out. He said highly specialised and expensive medical care needs to be centralised more. Kabátek sees a large scope for savings in the domestic healthcare system in the system of purchasing medicines. Strengthening primary care and prevention is also important, he added.
According to Kabátek, an increase in health insurance levies is politically unviable and the problem of financing the healthcare system will not be solved even by a possible increase in payments for the state insured. “Another source of funding is to increase patient deductibles,” said Kabátek, who believes that deductibles in the Czech Republic are currently very low. Supplementary commercial insurance is also under consideration, he said.
Source: CTK
