In spite of the 20 years that have elapsed since first transformations, reform of Poland’s healthcare system has yet to be completed. The Polish healthcare system is nominally an insurance-based system; in reality, however, a para-insurance system evolving around a governing bud- get system. Throughout the communistic period (1945-1989), it was a govern- mental budget-based system, with all hospitals state-owned and healthcare provided free of charge. The private sector share was minimal and limited to single doctors’ private practices.
First radical reforms following some trans- formation began in 1999, during the center-right government of Jerzy Buzek. To a considerable extent, reformation was modeled on Germany’s healthcare system, with certain elements from the British system also taken into account. Healthcare funds were created with the intention of financing healthcare in indi- vidual, regional areas. In addition, each fund was to function with significant independence. At the same time, a super- visory organization was to be set-up for the aforementioned insurance system, thus leveling disproportions between regions – ideals and actions that never took place. According to the intentions of the initiators, an insurance-based sys- tem with healthcare funds commercial- izing over a period of time would well serve its purpose. This never happened as politicians, wary of immense change that had already been introduced in other areas of everyday life, were put off by the threat of social conflict.
Incomplete Reform
As a result, healthcare reform came to a halt and remained incomplete despite the road map having been well chalked out. Furthermore, any claims regarding competition or possible admission of foreign capital remained valid solely on paper. It was the first time any form of cost management could have been per- haps successfully introduced, but sadly professional managers were lacking. Worse still, assuming funds had run out, the director of a hospital stopped accept- ing patients. Repercussions, following social pressure and this shameful event, were that the press and TV attacked the reformers’ good intentions, claiming that a free market in healthcare only brought enormous risks.
A further episode was the move by the left-wing cabinet of Leszek Miller, which took over by announcing its claim in favor of departure from the healthcare funds and replacement through a central National Health Fund – the Narodowy