Our healthcare system begun transformation from state central control and command system into regulated market with citizens as customers some 25 years ago. This process was not completed so far and our current system concentrates defects of both systems. As a result we can see lack of responsibility, unfairness, corruption, sword law, distorted incentives, conflicts of interest, long term unpredictability, insufficient adaptation on medicine and society development, structural problems etc. We have, in comparison with EU average, more acute beds, more physicians (with concurrent departmental a regional deficits of them), more ambulatory specialists (150 %), less GPs and the lowest private expenditures. There are inacceptable differences in payments for the same procedures in hospitals – base rate differs from 17 000 CZK to 45 000 CZK. The scope of covered services is not properly defined and there is no transparent system for introduction of new technologies. The list of troubles could be far longer, but this one is sufficient to justify need of change. Initiative Zdravotnictví 2.0 (Healthcare 2.0) is working on right a workable solutions and seeks public and political support for them.
7 paradoxes of the Czech healthcare system
1. Citizens have the right to the provision of healthcare services free of charge within the limits set by the law, but there are no limits set.
2. The Czech health care is calling for help, but the system has the lowest private expenditures in the EU.
3. There are places regionally where GPs are lacking, but compared with other EU member states, the number of GPs exceeds the EU average.
4. We have a competitive system of public healthcare insurance, but there is no competition.
5. All medical centers/services providers are equal before the law, but some are more equal than others.
6. The long-term care of chronically ill patients affects the results of the healthcare system and generates 80 % of the total costs - with no management.
7. Health and social care should work together hand in hand, as a continuum, but there is a thick division line between them instead.