You pay monthly he alth insurance contributions to the National He alth Fund, and when it comes, for example, to implanting an endoprosthesis, you cannot simply pay extra for one that will serve you for the rest of your life. As part of the insurance, you can get an implant that needs to be replaced in a few years. Do you want better? Pay the full amount.
The Act on Patient Rights and Patient Ombudsman , in force since June 5, 2009, contains a provision in which we read that the patient has the right to he alth services corresponding to the current medical knowledge . In other words, they can expect to be treated or diagnosed with the most up-to-date and proven methods of treatment. Unfortunately, however, this is only a theory, because in fact, each of us is treated with what is, or as allowed by the regulations of the National He alth Fund. It is not always related to the "current medical knowledge".
A wave of criticism has recently swept through the media against the Ministry of He alth, which opted for an extension of the contract with a private cataract clinic, and in fact for patients who had scheduled surgery dates. But this case drew public attention to the still unresolved problem of non-standard medical services. What does that mean? Well, in Polish conditions, the patient has no right to co-decide how he will be treated. For example, he cannot pay extra for him to have a better quality lens implanted in a clinic or hospital, a better endoprosthesis in the case of hip replacement, etc. Either you take what the National He alth Fund gives you or you will not be treated at all.
Controversial subsidies for treatment
Replacing lenses that eliminate cataracts for an additional fee aroused emotions disproportionate to the phenomenon itself. After all, many of us use non-standard services by visiting a dentist, gynecologist, ophthalmologist. We go there for our own money, because we want to have fillings made of better materials, to have a correctly collected cytology, ultrasound performed on modern equipment, etc. This is allowed, although these forms of medical care are guaranteed by the National He alth Fund. Patients do not ask for their share of the premium. Maybe because they are usually not very high costs. But when it is necessary to carry out an operation - the proportions change. Hardly anyone can afford to financeits whole. For years there was also the practice of paying extra for extra-standard treatment by the patient.
The National He alth Fund tolerated such offers from hospitals, especially since most of them underwent insurance through foundations or donations. Currently, despite no change in regulations, the National He alth Fund treats such activities as illegal, and hospitals that decide to accept subsidies are punished or lose contracts.
Meanwhile, many lawyers believe that choosing above-standard treatment is the patient's right. If a sick person waits for the planned procedure and wants to pay extra for a better quality prosthesis, or wants to get sick in better conditions, he should have the right to do so. After all, he did not throw anyone out of the waiting queue, he did not hurt anyone. So why are patients denied the right to invest in their own he alth?
Unfortunately, the thesis that the choice of treatment method is the patient's right is negated by the National He alth Fund, which imposes its own treatment conditions. He is a monopolist and can afford it.
System outside the system
The source of all the confusion is the imprecision of the guaranteed benefits package. Despite the judgment of the Constitutional Tribunal of 2004, which explicitly ordered the legislator to make an effort to define where in he alth care state support ends. Despite the introduction of the "basket" in 2010, the public standard of benefits is still undefined. Therefore, it is also not known what is above-standard treatment. But there are areas where the border is visible, and yet the National He alth Fund and the Ministry of He alth do not accept subsidies. For example, normal childbirth, described in the standards and "basket", does not provide for anesthesia, but the National He alth Fund claims that it is guaranteed. The National He alth Fund estimated the payment for the hospital for the admission of childbirth at approx. PLN 1700, of which the anesthesia itself costs approx. PLN 700. The procedure is underestimated. Hospitals would have to finance anesthesia, and they don't have the money to do so. Therefore, they collected a surcharge from their patients.
The introduction of the ban on surcharges translated into discomfort for those in labor. Currently, instead of real anesthesia, patients are administered, for example, laughing gas.
There is no he althcare system in the world that could provide all medical services free of charge to its citizens. That is why the problem of individual subsidies will come back like a boomerang.
Someday we will have to determine in which area, in what types of treatments, co-financing by patients is possible, in order to have money in the common cash register for complicated operations and for the treatment of those who do not have money for additional payments.
The premium stays with us
The indignation of patients who want "more" awakens and that if they wantuse a non-standard medical service, they have to repair their he alth outside the National He alth Fund.
You want to heal better, but leave your he alth insurance premium in the National He alth Fund. The patient cannot receive the amount provided for by the National He alth Fund for a given procedure and pay the difference. If he wants a better service, he is out of the system. He has to pay for everything himself. The argument that this only works for the rich is false. It is easier for everyone to pay some extra than to pay for the whole thing. The current system divides people. The rich will be able to pay out of pocket, the poor will not. Socially, a much better solution would be to support citizens' own he alth-promoting aspirations, because it also creates a chance for better treatment for people who have to count every penny.
Obvious solution
It is difficult to see hidden and unclean goals in subsidies to medical services. After all, both the Ministry of He alth and the National He alth Fund can control the quality of services offered "for an extra charge", you can regulate prices, as in the case of drugs, you can define the maximum level of subsidies, etc. But you cannot deny the reality!
At the pharmacy, we are asked whether we want a cheaper replacement, or we want to pay extra for a more expensive drug, and no one is surprised, no one protests. The pharmacist is even obliged to inform us about this possibility.
Unfortunately, in the case of treatment there is no such option. Meanwhile, it would be he althier if the same rules applied to replacing lenses, replacing joints, putting on plaster, treating teeth under the National He alth Fund and any other medical procedures. The act clearly states that the patient should have the items necessary for a given operation as part of the insurance. And so it is. If a patient can choose a lens that will eliminate astigmatism in addition to cataracts, or a hip prosthesis that will last for the rest of his life, why cannot he use it, why is the state against it? Moreover, it threatens the citizen that if he wants better medical service, he loses the right due to the monthly he alth insurance contribution. This is a limitation of the subjective right to he alth protection.