Health: a national issue

Lucyna Wisniewska

One can discussed whether a reform of health protection will be always a valid issue; whether one can form its final shape. Since one must be aware that there are no ideal solutions in this field because even the richest countries in the world cannot solve all problems concerning health care. There are groups even in the United States that have no health care at the fundamental level. Leaving this theoretical discussion aside one must state that today this issue must be a standby topic. And speaking about a reform of the health care system one must think of three areas: health insurance, way of management as well as organisation and access to health services. The idea of the government of the Citizen’s Platform – transformation of hospitals in commercial companies (all medical centres regardless of their financial situations and possibilities will be obliged to do that) is bad. Firstly, one should let financial means flow to the health care system, on the basis of appropriately evaluated health services. 4 % of the Gross National Product is too small. One should increase it at least to 6% as soon as possible. The means for health service must be at least doubled. If they are not provided, no transformations can improve the condition of hospitals. Medical centres will continue falling in debt because the lack of money is the main cause of this situation. What changes can commercial companies cause? Indeed, these hospitals that desire to become commercial companies should have the possibility of such transformations. But if some building belongs to State Treasury or some district or provincial self-government the company providing health services will have to hire this building. How much would health services cost in order to cover the depreciation of the equipment or renovation of the buildings? Self-governments as foundation organs should subsidize their subordinate units. But will that be sufficient? On should remember that the most important thing is not a form of ownership but the quality of medical services, which are commonly accessible and guaranteed by public means. For years the idea of a network of hospitals has been discussed and there have been various proposals concerning who should build such a network. But it is obvious that the one that guarantees services should assume this responsibility. Transferring of property to the unit that will soon complain that it cannot maintain its hospitals is opening a privatisation loop. Health services should be contracted by the National Health Fund from public means regardless the form of property of a given hospital. For example, if there is no a dialysis station in the region of Radom and there is a newly transformed private hospital that could guarantee such a treatment to the local patients the National Health Fund should contract such services for the local patients as soon as possible. The most important thing is always to provide access to health services to those who live in a given region. The main reason for creating networks of hospitals should be availability of services that these units can guarantee, i.e. the time in which a patient should reach a hospital to receive effective treatment. The time will be different for treating heart attacks and different for long-term care. If a patient with a heart attack is taken to hospital within an hour he can leave hospital as a completed cured person. The situation will be completely different in surgery, orthopaedics, genecology and obstetrics as well as in other health spheres. Access to treatment, i.e. the time to safely reach a hospital to receive a successful treatment, should be the decisive factor for the National Health Fund to contract services. One should create mechanisms that will secure cost-consuming procedures, e.g. in neurosurgery, cardiosurgery or rescue medicine. Another problem is the standard of hospitalisation of patients. It is nothing wrong to pay from additional insurance for extra facilities like a single room with a TV set. It is also worth returning to the concepts of several health-insurance funds (6-7 regional ones), which can compete with one another and guarantee the highest possible health care. But today the most important thing is that all Polish people have guaranteed health care, and that access to health services is as good as possible.

The Author is an MP and deputy director of the Provincial Specialist Hospital in Radom. She is the leader of the Republic Right Party in southern Mazowsze.

"Niedziela" 45/2008

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