Quack remedy

The government's plan to dump the three-year-old health care system of 17 regional Patients Funds is a colossal waste of money and yet another example of the Democratic Left Alliance's (SLD) cynical policy of putting short-term party goals above public interests. That the Patients Funds have largely been a disaster is no secret. Since Solidarity Election Action (AWS) introduced the decentralized health care system in 1999, the funds have come under heavy fire for poor management, corruption and a lack of funding. The Mazowiecka Patients Fund, which includes Warsaw, is considered one of the worst and receives the lion's share of criticism in media and political circles. And if things look bad in the capital, they tend to look bad everywhere.

But despite the problems plaguing most of the funds, not all of them are doing poorly. And for those that aren't faring well, scrapping them completely after millions have been invested in them isn't the answer. As our cover story shows, at least five funds are proving that a regional system can work. These regions - Śląska, Małopolska, Podkarpacka, Warmińsko-Mazurska and Wielkopolska - should be used as models for the other 12, not discarded with them. One of the toughest problems facing the funds are fraudulent claims by hospitals and clinics. To get more money from the funds to run their operations - or to line unscrupulous administrators' pockets - a number of hospital chiefs routinely submit bogus patient-treatment reimbursement requests. In other words, the same Jan Kowalski who had his right leg amputated three times last week could have the same limb amputated this week. There might be some humor in such examples if the end result - less money for better medical treatment for those who need it - weren't so tragic. The Śląska fund, for its part, has found a way around the problem of fraudulent claims. Its START computer system, which tracks the medical records of more than 4 million Silesian residents, has recently secured the return of more than zł. 700,000 from a hospital that cheated the fund. According to the fund's director, the computer system, which cost more than zł. 23 million ($5.47 million), has already helped deter other hospitals from submitting counterfeit claims.

But under the Health Ministry's plan to scrap the Patients Funds and return to a centralized network controlled in Warsaw, regions such as Śląska may have no choice but to junk their systems too. This is madness. Not only would chucking the funds waste millions spent developing them during the past three years, but a new national computer system would cost about zł. 500 million ($119 million) - money Poland doesn't have. Equally mind-boggling is the fact that the health minister, Mariusz Łapiński, has not even visited the Śląska Patients Fund to see whether anything can be gleaned from its experience. Evidently it's enough for SLD to back any plan that unravels the work of its predecessor, regardless of the cost to the budget or to Polish citizens.