Constitutional Court rules on health fees

On Wednesday the Constitutional Court ruled that health care reforms introduced by the government this year did not contradict the Czech constitution. The ruling came six months after the opposition Social Democrats and the Communists put forward petitions against the reforms, which, as of January 1, have required patients to pay 30 crowns (almost 2 US dollars) for every visit to the doctors’. The verdict was close with only 8 out of 15 members of the court ruling in favour.

Health Minister Tomáš Julínek, photo: CTK

There’s no question the government and specifically Health Minister Tomáš Julínek must have breathed a sigh of relief on Wednesday: it would have been more than a little embarrassing as well as damaging for him as well as the cabinet and the prime minister had the court ruled that the fees went against the Czech constitution and were indeed illegal. A lot hangs in the balance: Mirek Topolánek’s government introduced its first wave of fiscal reforms at the start of this year in order to cut down on public debt. Had the fees – which include 30 crowns per day for a visit to the general practitioners – been rolled back it would have arguably shattered the government’s plans and dampened any chances of additional reforms. As it stands, the health minister interpreted the court’s decision as confirmation the government could go ahead with additional plans.

But many in the public have never approved of the fees, not least those who were used to free health care under Communism, and it is not surprising many pensioners or lower-income families are not happy. On the other hand, in the first quarter, sources note, the fees have significantly helped reduce spending for example of health insurers by 20 percent, savings of 1.6 billion crowns (around 106 million US dollars). The payments also had a positive effect in reducing the number of unwarranted visits to the doctors’, which were also a drain on the system. Those are seen as positive effects, saving funds which were slipping through the cracks.

That’s not enough for the Social Democrats and Communists, many of whom are fuming. Some, on Wednesday charged the government had leaned on the Constitutional Court, others pointed to the fact it was only a slim victory - 8 judges to 7 out of a total 15 - although it would have actually required 9 votes to strike the fees down. The opposition is saying this is not the end of it: the increasingly embattled centre-right government can expect new counter-measures such as a broad public strike in late June. And both opposition parties are promising to do away with the fees if they win the next general election.

Photo: CTK

On the other hand, some changes can be expected even now and that has to do with pressure from within: the two smaller parties in government, the Christian Democrats and the Greens, have called for a revision of the fees, insisting that pensioners should exempted and that parents should not have to pay fees for their children and that will be the next battleground for the Civic Democrat health minister: he is reportedly willing to make an exception for toddlers up to the age of three, but the fight will be over children older than that and over pensioners.

Possible dissent from two or three government MPs can not be taken lightly, as the current coalition has only a fragile majority in Parliament leaning on the votes of two independents. That’s not an enviable position. In fact the health minister said on Wednesday if anybody thought he was now uncorking the champagne, they were mistaken. As some have noted, he may have won an important battle, but he has not won the war.