Private doctors' strike over late reimbursements set to go ahead

President of the Czech Medical Chamber David Rath and Prime Minister Jiri Paroubek, photo: CTK

Eleventh-hour negotiations by Prime Minister Jiri Paroubek have failed to avert private doctors' plans to strike over chronically late payments from the state-run insurance company. A working group of officials from the Health Ministry and the insurer were to meet on Wednesday to hammer out a solution, but associations of private practitioners expect little to come of it, and their members intend to shut down their surgeries on Thursday.

President of the Czech Medical Chamber David Rath and Prime Minister Jiri Paroubek,  photo: CTK
With an exasperated tone, Prime Minister Jiri Paroubek broke the news on Monday that three of the nation's twenty doctors associations will go ahead with plans for a general strike, and another three will publicly support the work stoppage.

Still hopeful a solution can be found, the Prime Minister appealed to the doctors "to take a different path". Mr Paroubek said he'd asked them to form a working body that would directly inform him of their concerns, and that he was committed to solving the problem of chronically late reimbursements.

But the chairman of the General Practitioners Association, Vaclav Smatlik, says his members are tired of waiting. He emerged from a meeting with the prime minister Monday unconvinced that a timely solution could be found.

"Since, for two months now, the insurers have not paid out reimbursements, the majority of --or even all surgeries-- will be closed; and I must say that today's meeting did not at all satisfy us."

Stories abound in the Czech media of private doctors dipping into their retirement savings to pay their nurses and meet other operating costs due to the backlog of repayments from the state-owned General Health Insurance Company, or VZP.

"As far as the doctors' strike is concerned, it's really a direct reflection of the fact that the medical health-care system in this country, essentially, has collapsed as a system," says private practitioner Dr Martin Jan Stransky.

He says the problem stems from the fact that while the Czech Republic has a system of socialised medicine -guaranteed state-level coverage - it has allowed the formation of nine competing insurance companies, including VZP, who manage the distribution and collection of health-care assets, with an eye for making a profit.

The insurers' complex points-based system for reimbursement also involves a lot of paperwork on both sides, increasing the time for processing each payment.

"They [insurers] in turn have been getting less and less money from the state due to the rising health-care expenditures which nobody, effectively, has been able to control," says Dr Stransky.

"So what you have is doctors perceiving that they are receiving low salaries, the insurance companies complaining that they are not getting enough money and completely independent entities negotiating against each other, as opposed to negotiating for each other."

In hopes of averting the doctors' strike, VZP even issued a public apology for the backlog last month to out-patients surgeries and hospitals, in paid advertisements in the major national newspapers. Even so, the insurers say it isn't their fault. They blame the government for not compensating the companies more for providing mandatory health insurance coverage to pensioners, for example, and the unemployed.