Healthcare, the market, and the public’s needs and interests

Social change in health care

- what kind of reform we need in Poland?

Romuald HollyMedical University in Lodz

Warsaw School of Economics

Insurance Institute in Poland

Warsaw, 2.06.2008

Social change in health care in Poland(controversy)

Agreement• the necessity of change - common awareness,• general consent to change,• agreement of the purposes,• acceptance of the way of change a reform,

Disagreement• the scope of the change,• the model and character of the health care system,• the way of transforming (revolutionary vs. evolutionary),• political, social and economic costs of the change.

Social change in health care in Poland (conditions)

• political will,

• government ability to carry out the change,

• specific Polish: social, cultural, legal, technological, demographic and economic conditions.

The reform strategic targets:

• increasing the amount of health services (medical procedures),

• improving the medical services quality,

• increasing the access to medical services,

• decreasing costs.

The reform major treats:

• political involvement,

• government disability,

• non-political, specific Polish conditions.

The reform major chances and opportunities:

• political neutrality of the reform designers,

• prakseologicaly legitimate economically rational assumptions,

• full arrangement of the whole health care system according to the insurance idea and insurance mechanisms.

The scope of subjects, character and kinds/types of health insurances are defined according to the construction of the guaranteed health services basket.

Then,

how to establish the basket? (as an operational reform target)

The basket as the criterion and the ground of the health care insurance system

in Poland

medical proceduresthe basket

supplementary ins.

alternative and/or parallel ins.

over/extra standard ins.

public basic ins.

Health Care Insurance Systemwe need in Poland

(recommended: Public-Private Insurance Partnership)

common / public, basic insurance

additional (I) private over/extra standard(complementary and/or and/orinsurance) mutual supplementary

additional (II)(alternative private basicand/or and/or over/extra standardparallel ins.) mutual supplementary