Czech Health Care in Economic Transformation

Abstract

In many developed countries, health care is now the cause of difficult economic, managerial and even political problems. In the Czech Republic, where fundamental changes in the health care system were absolutely necessary and long overdue, this situation was further complicated by the process of economic transformation and privatization, in which many changes occurred simultaneously. One of the major concerns of our health care transformation is the amendment of the short-comings of our health care system within the confines of our economy. The needs of the population are a result of the existing health status, which is not satisfactory. The basic trends of health care transformation were fully justified. But many changes in the economic environment, and the haste to change the existing situation might be the cause of some transformation being introduced without a sound conceptual framework. The introduction a new health care insurance system was a positive act but owing to the factors mentioned above, this system has many imperfections and weaknesses that could have been avoided. In particualar, the introduction of fee-for-service as the exclusive system of payments by the GHIO to health care units is inadequate in many ways. This motivates the health facilities to increase volume of services without regarding the quality. It was evident that it was necessary to discontinue the state ownership of health care establishments; it seems questionable, however, that methods of privatization commonly used in industry and business should also be the most suitable for health care organizations. It is difficult to understand why the type of non-profit organizations has not been applied here and why, up to now, no legal founding for such an organization has yet been prepared. Hospitals form a very important part of the health care system. They are faced with many serious problems, since changing the form of state ownership in the Czech Republic seems to be much more difficult than in the small scale health care units. Structural changes in medical staff do not present a sound basis for further privatization steps. This process improved neither the economy of these facilities nor the efficiency of the Czech Republic's health care system.