Give Łapiński the boot

How long are private healthcare providers going to have to wait before Health Minister Mariusz Łapiński gives some inkling about whether he plans to include them in his recentralized healthcare system? All he would have to do is say, yes, private cli-nics and hospitals will continue to receive state funding from healthcare-tax contributions under my reform. After all, that is what was agreed by the previous government under the 1999 overhaul of the healthcare system, and the reason so many doctors have started their own medical service facilities since then. If Łapiński were to favor public institutions under his scheme to dump the 17 regional Patients Funds and eliminate funding for private providers, the majority of these firms would go bankrupt. But, even more important, their patients would lose out. So why would he want to do that? Perhaps the dithering within the Democratic Left Alliance (SLD) has more to do with political infighting over support for Łapiński's plan - and whether it ought to be pursued - than the nuts and bolts of putting it to the government for debate on a final draft. But that's no salve for non-public healthcare institutions, which have been waiting for months to hear the details of the minister's plan to reestablish his grip on healthcare.

Returning to a Warsaw-based system, which would give the health minister control over disbursing funding for the entire country, rings eerily familiar of healthcare under communism, private doctors say. Rather than try to remedy the current scheme, which has been successful in almost a third of the 17 regions, private medical care providers are angry that the government has branded the entire 1999 reform a failure, vowing to dismantle it by next January. And, lest we forget, sacking Patients Funds' directors critical of the Health Ministry's plans along the way. Still, there are some private doctors close to the ministry who support the reform, making it unlikely that non-public healthcare groups would get snubbed under Łapiński's plan, if it ever gets off the ground. Why then, is the ministry so reluctant to divulge details of its scheme? With local elections set for Oct. 27, the go-vernment is desperate to prove to Poles that it cares about public healthcare. What it doesn't seem to realize, though, is that supporting all forms of healthcare, public or private, is in everyone's interest. It's really very simple: Use the Patients Funds' success stories, such as Śląska, Małopolska and Podkarpacka, as models for the ailing others. Don't jettison the entire system and return to one that would discourage private me-dical investment and quash healthy competition. If Łapiński has trouble swallowing that, he should be recalled from his post today.

Go Belka We can only imagine what went on behind closed doors last June when then Finance Minister Marek Belka butted heads with Prime Minister Leszek Miller about the 2003 budget, leading to Belka's resignation. Belka admitted in Stockholm last week that Miller was indeed the reason for his departure, saying that arguing with the prime minister was like entering a kicking contest with a horse. So much for the doubts about whether Miller is still in charge.