Abolition of health fees causes mayhem in selected pharmacies

The Czech Republic’s health care reform has sustained a severe blow. On Monday, the opposition Social Democrats fulfilled the promise which secured their victory in the autumn regional elections, as regional governments began covering the cost of health fees for patients. But there’s a hitch - the new system only applies to hospitals, pharmacies and other facilities owned by the individual regions, which some say restrains free competition.

Photo: CTK

“These are Bolshevik measures that are now being introduced in the regions”, Prime Minister Mirek Topolánek told reporters on Monday. He was referring to the new system under which all of the country’s regions – except Prague – began compensating patients for health fees. These were introduced by Mr Topolánek’s centre-right government at the beginning of last year as part of a broader health care reform.

The fees caused enormous controversy and became the pivot of the opposition Social Democrats’ election campaign in October’s regional elections. Their victory was so overwhelming that they could form regional governments everywhere expect Prague, and on Monday, they delivered on their promise to scrap the fees in all region-owned hospitals, pharmacies and other facilities. Social Democrat MP David Rath, now governor of the Central Bohemian region and the party’s shadow health minister, masterminded the abolition of health fees.

“People now have a choice. They can go to a facility – and this is mainly the case of pharmacies – where they pay no fees, but have to queue for some 20 or 30 minutes. Or they can go across the street to a private pharmacy which collects the fee, but there is no queue.”

Stanislav Havlíček, photo: CTK

On the first day that this went into force pharmacies where fees were not compulsory were swamped and reportedly, some of them were even forced to hire a security service to maintain order. The prime minister slammed the new regulation saying the country was heading back to communist times, when people queued up to buy bananas and toilet paper. But there is more than people’s discomfort at stake. Some health care professional organizations say the regions are in fact restricting economic competition. They only cover the fees for patients in their own establishments, whereas patients in other facilities, state-owned or private, still have to pay. Stanislav Havlíček is the head of the Czech Pharmacists’ Chamber.

“They are not covering it for all patients in the regions; it’s only for the few patients who are attended to in region-owned hospitals. So we think it’s discriminating against the rest of the patients, especially those who live far from those facilities.”

Mr Havlíček also says that one lawsuit has already been filed and others will soon follow.

“We know about one lawsuit, and we are preparing others for the other regions. Since the Czech Republic is a member of the Pharmaceutical Group of the European Union, we’ll also try to put the case before the European Commission to invite the EU to solve this problem in the Czech Republic.”

But the Social Democrats are resolved to get rid of the health fees for good. In December, they managed to revoke the respective legislation in Parliament’s lower house, and MPs are now going to vote on a softer version of the law, drafted by the Senate. If the coalition does not muster enough votes for the reform, the short history of health fees in the Czech Republic might soon be over.