Czechia’s healthcare timebomb, prevention schemes and greater efficiency needed now [Advocacy Lab Content]

The Czech healthcare system is on dangerous ground, and its financial sustainability is questioned by stakeholders, including the Czech health minister. They say a new focus on efficiency could help stop the downward trajectory.

The Czech Institute of Health Information and Statistics warns that personnel costs are rising in Czechia, together with chronic and acute illnesses in the general population – costs of innovation in the health sector are also skyrocketing. The healthcare insurance system and its financial sustainability are now said to be under serious pressure.

“Not only in the Czech Republic but all over Europe, there is a debate about how to proceed with the insurance system,” Czech Health Minister Vlastimil Válek (TOP 09, EPP) said during a debate organised by the Czech Chamber of Commerce in mid-March.

According to Válek, the pressing issue of the financial sustainability of the insurance system is visible in the discussions within the Council of the EU.

“I was surprised that during the Belgian Presidency, the first question raised was whether there is any way at all to prevent the ‘Americanisation’ of the European insurance system, which is extremely solidarity-based and social,” Válek added.

While healthcare coverage is often universal in Europe, where all citizens have at least basic care, the US system is different as not all US citizens have access to publicly funded insurance.

According to Válek, maintaining the European system will require conceptual changes.

“If we are to survive economically to 2040, we have no chance without this. We have to start doing something about it,” Válek warned.

Prevention is key

To keep universal coverage sustainable in Europe, stakeholders point out the need for developed preventive care.

Minister Válek emphasised that prevention keeps the citizens healthier, which is good for the financial sustainability of the system, as healthy people can work and pay taxes for longer.

“The key way is to increase prevention and thus to increase public health. This must be supported by the ministry, the government and the business sector,” Válek said.

According to the Czech health minister, citizens have to be motivated to be prevention-oriented. In addition to staying healthy, they should get other various benefits, including economic ones, such as vouchers for spa facilities.

“There should also be benefits for doctors who have healthy patients who have regular preventive check-ups,” Válek added.

The Czech minister is also open to the idea of having a pan-European prevention programme with clear objectives and funding.

Increase of efficiency

According to Tomáš Prouza, vice president of the Czech Chamber of Commerce, prevention and effectiveness of the health system are also priorities for employers.

“If we as employers understood anything during COVID, it is that prevention pays off,” Prouza said during the debate.

However, stakeholders also pointed out the need to increase the efficiency of the whole healthcare system.

“There is no doubt that we will have to pay more for healthcare. But the increase in public revenues cannot cover the entire expected increase in costs,” said Pavel Hroboň from the Advance Healthcare Management Institute, which focuses on health management education.

“The only solution to preserve the availability and quality of care is to increase the efficiency of the whole system. However, clear steps with a sufficiently large impact towards greater efficiency are still lacking in the Czech healthcare system,” Hroboň added.

Health insurance contributions

Prouza, who represents employers, also rejects the increase in health insurance contributions.

According to Prouza, employers are ready to support prevention to help ensure the population’s ability to work. On the other hand, Prouza said employers expect the government to focus “on achieving greater efficiency and effective use of public health insurance funds, developing a pluralistic system of health insurance companies and creating appropriate and sufficiently solidarity-based conditions for greater participation of patients in the financing of health care”.

Prouza added that an opportunity for change would be the revision of the Czech legislation on public health insurance.

Regarding the general efficiency of the health system, Hroboň from the Advance Healthcare Management Institute also calls for an innovative approach to health care. According to him, further development of distance health care or restructuring of the hospital network could help.

[By Aneta Zachová, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]

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