Expats to get access to state health care
The Polish government wants to undo a blunder it made when preparing health care reform in 1998: It forgot about expats who have work permits and pay taxes but don't have residency cards.
In the first three quarters of 1999, some 13,000 expats received work permits, the National Labor Office estimated. Of these, 579 were U.S. citizens, 8,300 were from Europe and 3,500 from Asia, mostly Vietnamese. According to Krzysztof Kaczmarek, director of the National Labor Office, 2,500 work permits were issued to highly qualified managers from Western Europe and the United States.
When reforms finally took effect on Jan. 1, 1999, expats could no longer get treatment at state medical centers. But now the government has prepared an amended bill that includes expats in the new system.
"The bill's goal is to regulate access to the new health insurance system and expats will benefit the most from the change," said Zbigniewa Nowodworska, spokeswoman for Anna Knysok, the government's health care reform coordinator. "It's possible the Sejm will debate on the bill in its second reading on Feb. 17," she said.
Presently, only Polish citizens, foreigners with residence cards, diplomats and foreign academics employed at Polish universities can register at Patients Funds and make health-care contributions.
Since the reforms of January 1999, other expats have come to regional Patients Funds' offices asking whether they could pay the contribution anyway. "Under the circumstances, we could do nothing for them," said Ewa Dzialowska of the press office for the Mazowiecka Patients Fund. "Our fund is particularly interested in changing the law because it's in Warsaw that most expats work."
Now the government promises that the number of categories of foreigners eligible for state health-care services will increase. According to Nowodworska, the amendment would settle the awkward situation of foreign students in Poland, who would also be included in the new system. Expats with work permits will be treated like Polish citizens who work and pay taxes. Moreover, "their families will be also insured," Nowodworska said. Generally, "health-care contributions can be paid by a family member who supports the family, thus automatically insuring the rest of the family. This rule will now apply for expats too."
Under the reform, 17 regional Patients Funds cover the medical costs of their member patients by contracting hospitals and clinics and paying for treatment of members. The funds for this new system come from a 7.5% contribution deducted from personal income taxes. Regional funds pay state, or increasingly private medical centers and hospitals with which they have signed contracts fees per registered patient and set for each type of treatment.
But many expats may have problems getting used to the still inadequate medical services provided by the government's new system. Those for whom money is not a major impediment may stick to private services. "From the very beginning, we have employed bilingual personnel, as our clients were mainly expats," said Joanna Sajkowska, public relations specialist from Centrum Medicover, a private medical center established in 1995.
