With more than 37 000 doctors and 125 000 hospital beds for its 10.3 million people, the Czech Republic has one of the world's highest ratio of doctors and beds to population. According to the long term programme of the Ministry of Health, which was published in December 1995, both the number of doctors and hospital beds should be reduced.
Due to the complexity of privatising the health care system, privatisation has proceeded more slowly than in other sectors. In 1995 the privatisation of all family doctors and dental practices and out-patients clinics was completed. The private sector now provides about 90% of out-patient care.
Privatisation plans for 136 of the country's 188 hospitals, have been approved. Thirty four were privatised through direct sale and 32 transferred free-of-charge to communities. Only some ten smaller hospitals have been completely privatised.
The remaining 70 hospitals are to be privatised, but privatisation plans for these facilities have yet to be approved. Privatisation will not limit the access of the population to health care. Health care in the private sector will be provided to all citizens and district authorities will be responsible for health care in the regions.
Doctors and hospitals are paid through a fee for service system by the insurance companies, which are in turn financed by a mandatory 13.5% deduction from salaries and private income. For pensioners, children and the unemployed, contributions are paid by the state.
BREAKDOWN OF EMPLOYER AND EMPLOYEE INSURANCE CONTRIBUTIONS Employer payable Employee payable health insurance 9% 4.5 % social insurance 26 % 8 % pension fund 19.5% 6.5% sickness benefit 3.3% 1.1% unemployment fund 3.2% 0.4% TOTAL 35% 12.5%
The General Health Insurance Company (VZP) is the biggest health insurance company, covering about 75% of inhabitants. It is guaranteed by the government. There are 26 other health insurance companies operating in CR. This current number is not sustainable for the size of the Czech market and the number of health insurance operators is expected to be reduced. New measures are to be introduced by the Government, placing more stringent controls over health insurance companies, namely over their financing. The introduction of individual accounts is planned for the future.
Ensuring the quality of health care and basic facilities will be administered through central and district authorities.
To limit the increasing expenditure on prescription drugs through insurance payments, a new listing of drugs was created in 1995.
All these measures are intended to improve the effectiveness of the Czech health care system and make the system financially self-sufficient, securing the financial sources for increasing health care personnel wage levels without resorting to increased Government spending.
Source: Czech Health Statistics Yearbook 1994 Long Term Programme of the Ministry of Health (published in Healthcare news, December 15th, 1995)
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