Government proposal may see patients paying for ambulance trips

A new proposal by the Czech Health Minister Tomáš Julínek will see some Czech patients having to pay for ambulance trips. At present, such journeys are covered by health insurance, but if the changes are approved, come next January, patients may have to pay for ambulances the same way they pay for taxis.

Czech healthcare reform is undoubtedly an explosive issue. Many Czechs are already deeply opposed to the recent introduction of doctor’s visitation fees, arguing that free-at-the-point-of-delivery healthcare is guaranteed in the Czech constitution. However, supporters of such reforms argue that the Czech Republic must reduce expenditures and also increase responsibility in a populace often described as being almost hypochondriac in nature.

New proposals by the Health Minister Tomáš Julínek would, according to reports, stipulate that in cases where patients are being returned home following a hospital stay, a free ambulance could only be provided if the patient was escorted by a healthcare specialist. Otherwise, a charge of around 27 crowns per kilometre – the same as a taxi – will be levied. Critics see that as a waste of resources – why waste trained medical staff escorting fit and healthy people home? The government has defended the plan, arguing that healthy patients do not require such free services at all.

Dr Michal Sejka is a spokesperson for the Czech Medical Chamber. He believes that not enough is yet known about the precise details of the government proposals:

“The situation is not at all clear because the proposal does not set out whether these trips should or should not be paid for by health insurance cover. There are certain paragraphs in the proposals that say that certain trips should not be covered, but the details of that are not clear and in fact the proposal says that it is the doctor that should decide.”

As usual, the divisive issue of health reform has seen various camps pro and against setting their positions in stone. The Social Democrat opposition remains firmly opposed to the idea – the party also having opposed the introduction of doctor’s visitation fees. The Czech Union of Health Transportation Workers is also opposed to the move arguing that the government is shifting its healthcare responsibilities onto the patient.

But Dr Sejka of the Czech Medical Chamber believes that the proposals are logical.

“Much of Europe has similar systems in place, because sometimes relatives, instead of coming to pick up their loved one themselves, let them be taken home by ambulance. And such a service need not be considered as a legitimate part of healthcare obligations. But the important question is how this proposal will end up being formulated. Questions of whether this service will be completely taken out of health insurance or how exactly it will be paid for are simply not known at this time.”

If the new plans are approved, they will come into effect in January. Healthcare reformers will certainly argue that such moves are not enough, while others will say they go too far. As is often the case in the Czech Republic, pragmatic policy is often lost along the way.