Healthcare, the market, and the public

1
Healthcare, the market, and the publics needs
and interests

• Social change in health care
• - what kind of reform we need in Poland?

Romuald Holly Medical University in Lodz Warsaw
School of Economics Insurance Institute in
Poland Warsaw, 2.06.2008
2
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.

3
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.

4
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.

5
The reform major treats

• political involvement,
• government disability,
• non-political, specific Polish conditions.

6
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.

7

• 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)

8
The basket as the criterion and the ground of the
health care insurance system in Poland
over/extra standard ins.
supplementary ins.
public basic ins.
alternative and/or parallel ins.
medical procedures
the basket
9
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/or
• insurance) mutual supplementary
• additional (II)
• (alternative private basic
• and/or and/or over/extra standard
• parallel ins.) mutual supplementary