Health insurance system in the Czech Republic. Karel Dušek Bruxelles, 5 th March 2004
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1 Health insurance system in the Czech Republic Karel Dušek Bruxelles, 5 th March 2004
2 Introduction of the system: 1. Public health insurance system - after Before Czech health service 3. Mandatory system - the insurance on individual basis 3. Principle of solidarity healthy people with ill rich with poor
3 Insurance premium 1. Insured persons: employees selfemployed persons is paid by: persons without taxable income 2. Employers 3. The Czech state 4. Special act 592/1992 fixed: amouts of premium, penalty and payment methods
4 The amount of insurance premium paid per month by: Employees - 13,5 % of gross wage (4,5 %) Employers - 9 % of gross wages of employees Persons without taxable income CZK Selfemployed persons - the minimum amount 1071 CZK Czech state CZK
5 Redistribution of the insurance premium: Insurance premium paid by the Czech state 60 % of the collected amount are redistributed Redistribution is provided by General Health Insurance Fund of the Czech Republic Reform from 2005: 100 % of the amount should be redistibuted?
6 Any insured person is entitled: to choose health insurance fund to choose doctor or health service facility - signed a contract with health insurance fund to participate in the control of provided health care
7 Any insured person is obliged: to inform insurance fund about any facts affecting the progress of insurance to pay premium to health insurance fund to observe any precaution directed to prevent and eliminate diseases
8 Medical care abroad for our insurers: The necessary emergency treatment is paid: in the same amount as in the Czech Republic International agreements about social security: Austria, Germany, Luxemburg, necessary emergency care in the amount which is paid in these countries
9 Payments for health care: The special act 48/1997 Contracts between health insurance fund and providers Negotiations between health insurance funds and relevant professional associations of providers (segments of providers) List of Treatments issued by Czech Ministry of Health types of treatment paid from health insurance point ratings
10 Segments of providers (according to the type of the health care): - general practitioners - specialized emergency care - dental care - aftercare - institutional care - medical transport - physiotherapy - laboratory - bath and spa care
11 The outcome of negotiations about payments: 1. Agreement was reached 2. Agreement was not reached Public interest Czech Ministry of Health must decide: result: Form of legal regulations methods and financial compensations for providers valid for a period of one calendar half - year
12 Health insuraance funds in the Czech Republic: 1) General Health Insurance Fund ot the Czech Republic - established by special act 551/ % of population use services of GHIF 2) 8 employee health insurance funds - established by Czech Ministry of Health - the act 280/ % of population
13 The Structure of the health insurance fund: The self government bodies of HIF: administration board supervisory board The bodies consist of: representatives of insured persons employers Czech state vote: 1/3-1/3-1/3
14 Basic management documents of health insurance fund: Health insurance plan for forthcoming calendar year Annual report for previous calendar year: final accounts auditor s report
15 Basic management documents of health insurance fund: The documents of an employee health insurance fund must be authorized by the Czech government, the documents of the GHIF must be authorized by the Czech Parliament
16 Ten years history of the health insurance system in the Czech Republic: Financial flows are stabilized Health of population has apparently improved - life expectancy High quality of pharmaceuticals, medical material, technical equipment Material conditions of providers have been improved
17 Challenges for future: High priority of justified interest of the Czech subjects in the system Maintaince of the solidarity Motivation to responsible and economical behaviour Maximal efficiency of resource utilization Multi source financing of health care Interconnection of health, sickness and accident insurance Installation pay system DRG To prohibit interference of the government to contracts between HIF and providers of health care What must be paid from the public health insurance system? Hospitals and ambulatory physicians Reducing of the network of health institutions To slow down the increase in the cost for drugs
18 Join the European Union: 1. Increase in costs for HIF 2. Higher price level in member countries 3. Free movement of people and services 4. Council Regulations 1408/71 and 574/72 5. Clear specification of the necessary emergency care 6. New groups of insurers for HIF: people who long term stay abroad etc.
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