Parliament approves first stage of controversial health reform

The Czech Parliament has approved the first stage of the government’s health care reform. The three-party coalition, which has a majority in the lower house, pushed the bill through despite opposition from the back-benches that it will create a socially unjust, two-tier health system. The Social Democrats’ shadow health minister David Rath announced that his party would do everything it could to prevent the new legislation from being implemented – including taking it to court. Health care expert Dr. Martin Stránský speaks about whether these criticisms are justified and what the main changes are that this reform will bring.

“What the main changes that the health reform will bring are, remains a matter of debate, because on the one hand, there is a ruling government now which has a very specific reform package, and then there is a minister of health who is picking and choosing certain parts of that package at will, which may be a good thing, but he is also bringing in some of his own ideas. The problem is that this minister was not a member of the negotiating team.

“Most people seem to agree that there are two main thrusts, the first is that finally, for the first time, it will be exactly defined just what is and is not covered under the so-called state health care system, and second of all, there is going to be added emphasis on cost-control as far as the insurance companies are concerned on one hand, and as far as purchasing is concerned on the other hand, specifically, there are moves now to make the buying of medical supplies more central and more transparent and to decrease corruption, which remains a huge problem in this country.

David Rath
From what I understand, the definition of what exactly will fall under standard care is still in discussion. Isn’t that a problematic factor?

“That is the problematic factor, because in typical Czech fashion, they are trying to reinvent the wheel instead of taking a look at what has already been done in practically every other country and what is already out there. On the one hand, they are fighting amongst themselves just as to who is going to determine what the standard of care is, and then there is a big debate as to how that is going to be determined.

“The simple solution here would be to simply look at everything that is being done and call that the current standard of care, and then simply try to modify it on a yearly basis based on certain parameters and outcomes.”

The opposition has basically slammed this reform and deputy David Rath even said that a complaint at the Constitutional Court was an option. How do you see the criticism from the opposition?

Health Minister Leoš Heger, photo: CTK
“The criticism is purely political and it is very populist, as is the case in every country that is grappling with its health care system, which is probably every country at this point. The same is true in the United States, just as a side note, you can see what happened in America when President Obama introduced the notion that the government is going to step in and cover the uninsured.

“So here, the Social Democrats, who are traditionally left-of-center, are holding on to the idea that the state is going to be the guarantor for everything and that the state should take care of the average citizen at all costs, while the current government and the reform programs are pushing through the notion, which is politically a very dangerous notion in this country, that health care costs money. And that if you go to the doctor that somebody has to pay for it, and that that somebody is the state, but that the state is really you.

Martin Stránský
This is a very drastic notion, especially for Czechs, who are used to social handouts, for many, many years, and are still getting them at many levels. So it’s a political battle and it is a battle about perceptions and not so much facts.

“From my point of view, the good news is that the current minister is managing to correctly push through the notion slowly, onto the general populous, that health care does indeed costs money and that it needs to be viewed in practical terms.”