Wednesday, March 29, 2006

Czech meltdown

http://www.praguepost.com/P03/2005/Art/1222/news1.php

Physicians protest over delays in payments by VZP insurer By Peter KononczukStaff Writer, The Prague PostSeptember 28, 2005
Private physicians will close their offices for the first time ever Oct. 6 to protest a deepening crisis in health care funding.
The one-day strike by thousands of general practitioners follows a fierce three-way row, with doctors' unions, the Health Ministry and the nation's largest insurance provider trading accusations about who is to blame for the health system's massive cash problems.
Many of the country's 6,800 pharmacists are likely to join the protest, though the Czech Pharmacists' Association said this will take the form of pharmacies closing for just an hour from noon.
Jirí Suttner, spokesman for the General Health Insurance Company (VZP), the country's largest health insurer, said he was not surprised at the announcement of the strike. "We see it as an extreme solution, the result of dissatisfaction or even despair over the way the health care system is shaped in the Czech Republic."
VZP provides medical insurance for 65 percent of the population.
David Rath, president of the Czech Doctors' Association, which has some 40,000 members, said that hospitals will remain open during the strike, adding that the action "should not limit medical care in any serious way," particularly for patients with acute problems.
However, not all doctors agree, and not all support a strike. Private physician Jaroslav Henzl, 46, who has a practice in Prague 4, said, "A doctor who closes his office is limiting care offered to his patients, as well as limiting the number of his clients. That's not a good way to go."
Rath says the state-controlled VZP is creating huge problems for doctors, managing its extensive debts by reimbursing physicians some 70 days after they provide medical care, even though it's supposed to pay within 20 days. He added that payment delays threaten the livelihood of some physicians and that doctors without financial reserves have had to take out loans to tide them over. Others have been known to take temporary work at clinics in Western Europe on a regular basis.
Rath, a long-term critic of VZP, accuses the insurance firm of poor financial management and is demanding that its head be sacked and the company to be forced into state administration.
However, VZP denies responsibility and blames the Health Ministry for its cash deficit — a key issue in the country's ongoing problems with public finance reform.
VZP Director Jirina Musílková says that the Health Ministry has fixed prices for medical services that are higher than revenue collected from health insurance contributions. VZP spokesman Suttner said the company is 10 billion Kc ($408 million) in the red, while the total debts of the country's nine health insurance firms including VZP are expected to grow to some 14 billion Kc by the end of the year.
Suttner said VZP has limited room to maneuver, given that the law dictates up to 80 percent of insurers' expenses, from hospital fees to drug prices, and all their income, including client payments.

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