Poland : Health system review

TitlePoland : Health system review
Publication TypeBook
Year of Publication2011
AuthorsPanteli D, Sagan A
Secondary AuthorsMossialos E, Busse R, Figueras J, McKee M, Saltman R
Series TitleHealth Systems in Transition
Volume13 (8)
Number of Pages193 p.
PublisherWHO Regional Office for Europe
CityCopenhagen
ISBN1817-6127
KeywordsDelivery of health Care; Evaluation Studies; Financing, Health; Health care Reform; Health System Plans; Poland
AbstractSince the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) – the sole payer in the system – is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-ofpocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures, particularly in areas such as pharmaceuticals, are highly regressive.
URLhttp://www.euro.who.int/__data/assets/pdf_file/0018/163053/e96443.pdf
Tags: