Vol. 12 Issue 3 Year 2014

2014

Publication date: 2014

Licence: None

Editorial team

Scientific Editor dr hab. nauk ekon. Christoph Sowada

Issue content

Źródła finansowania opieki zdrowotnej

Stanisława Golinowska, Marzena Tambor

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 205-217

https://doi.org/10.4467/20842627OZ.14.022.3440

The question how to mobilize financial resources for health care is one of the most frequently asked questions in health care debates. It is also relevant in Poland, where although various health care reforms in the last two decades, there is still no consensus on how health care should be funded.

The ambiguous nature of health care services indicates that both public and private methods of funding should be applied in order to obtain the best value for money. In practice both private and public sources are used. However wealthier European countries, rely strongly on public solidarity-based funding. Whereas in the framework of public sources there is a never ending debate what is more effective: general taxation or insurance contribution.

Debate on private sources is still on the agenda as well, particularly in post socialistic countries. Private insurance or co-payment and what kind in both cases are the main question.

In this paper, we present a review of public and private methods of health care funding focusing on their main characteristics, their application in European countries, and their effects. TQhe analysis relies on secondary data, i.e. a review of the literature and health expenditure databases.

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Pomoc dla zdrowia. Finansowanie ochrony zdrowia ze źródeł pozakrajowych

Paulina Miśkiewicz

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 218-227

https://doi.org/10.4467/20842627OZ.14.023.3441

Development assistance plays a key role in many areas of health care and represents a significant source of funding in many low- and middle-income countries. In recent years, global expenditure for health have increased considerably, including development aid. However, it is still insufficient and not meeting the needs. Many countries can not ensure within their own financial resources to achieve economic development and improve the well-being of its citizens, including universal access to a minimum level of health care. International society, including developed countries and international organizations plays significant role by providing financial assistance to less and middle developed countries. Over the years, the main challenge was to ensure the effectiveness of aid. In order to ensure greater coordination and transparency a set of principles were adopted in Paris Declaration and the Accra Action Programme.

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Rola funduszy strukturalnych Unii Europejskiej w finansowaniu inwestycji w obszarze ochrony zdrowia w Polsce

Katarzyna Dubas-Jakóbczyk

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 228-238

https://doi.org/10.4467/20842627OZ.14.024.3442

The article presents the analysis of European Union structural funds’ role in financing investments in Polish heath care sector. The analysis includes investments in physical assets (mainly equipment, renovations) as well all projects related to human capital (education). Distinguishing features of EU co-financed investments projects are presented. The analysis is focused on the period 2007–2013, however some basic assumptions for the new financial perspective (2014–2020) ware also discussed. The outcomes of the analysis confirm that EU structural funds constitute an important (and in many cases major) source of financing investments in Polish health care sector. However, at the macro level the is a strong need for introduction of coordination policies and rationalization mechanisms (linking the investments planning with the actual heath needs and sustainability prognosis).

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The financial burden of out-of-pocket patient payments in the European Union and accession countries:

Results of a systematic literature review

Konstantin Moser, Milena Pavlova , Wim Groot

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 239-247

https://doi.org/10.4467/20842627OZ.14.025.3443

A major issue for public health policy is to reduce the poverty and catastrophic effects of out-of-pocket payments. This paper reviews empirical studies that analyze the financial burden of out-of-pocket payments and factors that are associated with this burden for households in the EU and accession countries. The method of systematic literature review is applied. Poverty effects appear to be independent of geographical area. Catastrophic healthcare expenditure ranges from a bit less than 0.05% to nearly 4%, and the impoverishment due to out-of-pocket payments is also up to 4%. Analyses carried out in single countries reveal that living in a household with a pensioner contributes most to high payments for health care. The results support calls for health policy to prevent the burden of out-of-pocket payments, especially for pharmaceutical expenditure. Special attention should be paid to risk groups such as pensioners, female headed households and low income households.

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Medyczne konta oszczędnościowe jako metoda finansowania świadczeń zdrowotnych. Dotychczasowe rezultaty ich funkcjonowania w świecie i perspektywa dla Europy

Irmina Jurkiewicz-Świętek

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 248-257

https://doi.org/10.4467/20842627OZ.14.026.3444

Many countries around the world are concerned by growth in health care spending. Yet it is an unavoidable process resulting from new medical technologies, ageing populations and high expectations of patients. Therefore, the actual goal of any new solution in health care system, is slowing down the process of health care expenditures growth. One of the relatively new solution are medical savings accounts (MSAs; or health savings accounts, HSAs). The aim of this article is to present MSAs as health care financing method, its structure and implementation results in chosen countries. A short deliberation on MSAs’ place in Europe is presented.

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Zadłużenie publicznych szpitali w Polsce w latach 2005–2014. Nierozwiązany problem zobowiązań wymagalnych

Christoph Sowada

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 258-270

https://doi.org/10.4467/20842627OZ.14.027.3445

Running up debts of public hospitals (independent health care units) constitutes an immanent feature of the Polish health care sector. Even though the introduction of the Public Assistance and Restructuring of Public Health Care Units Act of 15 April 2005 contributed to a reduction of overdue debts from 6.2 billion zloty in the middle of 2005 to about 2.1 billion zloty at the end of September 2014, they still remain quite high. Among units with the highest debts are the biggest and most important for the system central institutes and university hospitals. One can also observe regional variation of debts size. The most indebted are the facilities located in the mazowieckie voivodship though the public financing of hospitals in this region is the highest in the country. Therefore simple increasing of public financing seems not to be the right solution. The most important factors that contribute to the financial imbalance of public hospitals in Poland are rooted in the area of law regulations and health sector governance.

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Ocena proponowanych zmian w finansowaniu opieki onkologicznej jako reorientacja paradygmatu w systemie ochrony zdrowia w Polsce

Barbara Więckowska, Janusz Dagiel, Andrzej Tolarczyk

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 271-283

https://doi.org/10.4467/20842627OZ.14.028.3446

The aim of the article is the analysis of cancer spending in Poland, which accounted to PLN 6.3 billion in 2011. It will be shown that the share of healthcare spending for cancer care is about the same as in other countries however the structure of spending is much different e.g. excessive inpatient hospitalisation in chemotherapy, radiotherapy and for diagnosis accounts for PLN 1.3 billion or 22% of total cancer spending. This is the result of economically rational and driven by the current modalities of healthcare service financing in Poland of health providers’ behaviour. At the same time it is a huge window of opportunity to restructure the financing mechanism for oncology in Poland. At the end of article we present how the planned reform of oncological care in Poland will change the economic incentives for providers and the expected results of it.

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Skutki dyrektywy o stosowaniu praw pacjenta w opiece transgranicznej w zakresie uprawnień pacjentów, zobowiązań świadczeniodawców oraz w sferze organizacji, koordynacji i finansowania świadczeń

Anna Mokrzycka , Iwona Kowalska, Katarzyna Badora-Musiał, Maciej Rogala

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 284-296

https://doi.org/10.4467/20842627OZ.14.029.3447

The so called cross border care directive of European Union follows the long process of European Court of Justice judgments concerning regulation of patient’s right in respect to health services delivered outside the country of health insurance, specifically the planned procedures or treatment not available in the country of patient origin. At this moment the directive is still being transformed into domestic systems however, there are still important obstacles and problems caused by the implementation process. The paper concerns some specific aspects of the above mentioned implementation results, showing also the wider context of the previous attempts focused on the matter solving in EU, mostly describing the legal background and crucial political approaches. It briefly describes such questions like: pre-authorization requirements, subjective obstacles regarding implementation, national contact points problems, need for the legislation novelisation, base reimbursement problems, national systems protection, providers responsibility and some coordination of services aspects in relation to the described directive.

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Events

Promocja zdrowia i ochrona przed ryzykiem – działania na rzecz seniorów „Pro Health 65+”

Stanisława Golinowska

Public Health and Governance, Volume 12, Issue 3, 2014, pp. 297-298

https://doi.org/10.4467/20842627OZ.14.030.3448

Działania Drugiego Programu Zdrowia Unii Europejskiej (UE) „Razem po zdrowie” (2008–2013) koncentrowały się na trzech głównych celach: (1) poprawy zabezpieczenia zdrowia Europejczyków, (2) promocji zdrowia i zmniejszania nierówności w zdrowiu oraz (3) tworzenia systemu przekazywania społeczeństwu informacji oraz wiedzy na temat zdrowia.

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Słowa kluczowe: health care funding, out-of-pocket health expenditure, social health insurance, development aid, health, health care financing, co-financing, European Union, grants, health care, investments, catastrophic effects, European Union, out-of-pocket payments, poverty, China, Europe, health savings accounts, medical savings accounts, Singapore, South Africa, United States, hospital debts, hospital financing by NHF, overdue liabilities, cancer spending, economic incentives in healthcare system, healthcare financing, oncology, abroad treatment, cross border care, health systems protection, patient’s rigths, planned health services, UE directive implementation

Volume 12, Issue 3

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2014