Government bill to revamp healthcare picks up steam

by Anna Kocińska

"Over the last three years we've created a system that we should develop and improve rather than destroy"The government's plan to regain control over public healthcare may happen as early as June, a spokeswoman for the Health Ministry said last week.
The ministry, which has been working on a draft bill aimed at abolishing the three-year-old system of 17 regional Patients' Funds, said it wants to restore order and accountability within the public healthcare system. The Patients' Funds have been heavily criticized since the previous government introduced them in 1999, mainly because of questionable spending policy and mounting bureaucracy. Critics of the new bill, however, say the legislation means a return to central planning.
But Renata Furman, spokeswoman for Health Minister Mariusz Łapiński, said the ministry's goal is to create one coherent healthcare policy as opposed to different schemes run by the 17 Patients' Funds. To achieve this, Łapiński has been personally monitoring progress on the bill, under which a centralized national health fund would be created to oversee the regional ones.
"The national health fund will depend on the ministry to provide the minister with direct control over the entire system," Furman said. The legislative process will last until June, she added. Ambitious plan
When the current system was introduced in 1999, it aimed to decentralize the old one under which funds were distributed from the central government to the Health Ministry, which then doled out cash to hospitals and clinics without regard to demand for medical services. The new system is financed by individual contributions deducted from personal income taxes that are transferred to the 17 regional funds, which are then responsible for contracting and financing medical services in the public and private sectors.
Last week the Patients' Funds criticized the government's plan to dismantle the system. While many of the funds have been taken to task for being ineffective and overly bureaucratic, several of them, such as Małopolska Kasa Chorych, Śląska Kasa Chorych, Podkarpacka Kasa Chorych and Warmińsko-Mazurska Kasa Chorych, have proved financially viable.
"The current government inherited an instrument that allows it to manage and calculate the costs of healthcare," said Jacek Kukurba, director of Małopolska Kasa Chorych. "It's like a watch that needs some fixing but the government decided to dismantle it without knowing what will happen after putting it together again. Over the last three years we've created a system that we should develop and improve rather than destroy."
Though some of the funds have been accused of scandalous spending practices - prompting SLD and other parties to take action - others are proving that the new system can work efficiently. Model fund
To crack down on forged prescriptions, Śląska Kasa Chorych introduced special forms that have proven effective. As a result, the cash saved lowers the costs of drug refunds for patients. "At the moment refunding accounts for 18% of our total budget but we hope the new prescription forms will provide a 10% savings," said Jacek Kopacz, spokesman for Śląska Kasa Chorych. And thanks to a computer system, the fund is able to settle accounts with medical-services providers on a timelier basis.
"Prime Minister (Leszek) Miller said his government would introduce a special database of medical services, but we have had one in place for seven years in Silesia," Kopacz said. "Nobody from the ministry has ever visited us to see how it all works but instead of improving things they want to destroy it all."
At the same time, critics accuse the funds of creating their own fiefdoms and promoting 17 different healthcare policies. Kukurba, however, praises their independence, saying it is the only way to meet the regions' particular needs. According to Kukurba, the minister's concept to establish a national healthcare fund simply means government control over regional cash flow.