The concept of good privatization of health care: synergy of freedom and regulation

Piotr Kłodziński|
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The concept of privatization of health care and private health insurance often raises controversy and discussions about the role of the state in providing medical care. Today, the confusion was caused by Konfederat, who, although he identifies himself as a representative of a party with libertarian beliefs, presented populist demands. Unfortunately, he somewhat discredited the idea of freedom, an issue that requires much deeper thought and debate, and not overly simple election slogans. In the following article, I present an alternative vision of the privatization of health care, which probably optimally combines elements of freedom and regulation. This is a ready recipe for all those in power to quickly heal the system.

Point 1: State regulation of the benefit package

The first step in the proposed concept is to maintain state regulation of the benefit package. This means that the government would still define the minimum scope of medical services that must be provided to all citizens. This benefit package would constitute the basis of health care and indicate what benefits citizens can count on in each insurance company. It already exists today - this is the scope of services reimbursed by the National Health Fund. And it should not be subject to downward changes, but newer therapies should be gradually introduced. This is this critically important state element.

Point 2: Participation of private insurance companies

A key element of this proposal is opening the door to private health insurers who would operate outside the National Health Fund (NFZ). Citizens would have the right to choose between the public health service and private insurers, which would offer a wider range of medical services and comfortable service conditions. Ultimately, everyone would probably withdraw from the National Health Fund, and private, competing insurance companies would be created in their place. Competition almost always means higher quality of services for the customer, i.e. the patient.

Point 3: Redistribution of non-paying contributions previously supported by the state budget

An important aspect of the proposed model is the redistribution of people who do not pay health insurance contributions. Currently, the state covers the costs of treating such people through the National Health Fund. In the new concept, these people would ultimately be distributed proportionally between private health insurers. This would require the introduction of appropriate mechanisms and regulations to ensure that these people receive medical services equivalent to those paying contributions to private insurers. So, let's say that Insurance Company 1 would have to guarantee the same standard of service to those who signed up for it as to the pensioner from Koszalin who will be selected by lot. Since we are paying for it anyway, let's leave it in private hands.

Point 4: Reducing personal income tax and eliminating state subsidies

In order to equalize the costs that would be borne by people paying contributions, due to the redistribution of people not paying contributions, I propose reducing the personal income tax (PIT) by the subsidy that is currently paid by the state budget to the National Health Fund (e.g. for the unemployed). This would mean that citizens would have more money at their disposal to pay for private health insurance. At the same time, the state would gradually reduce financial subsidies transferred to the National Health Fund to zero. This means that instead of going to the National Health Fund, this money would go to our wallets, although ultimately the people paying contributions would still have to pay slightly higher premiums to the insurance company. But the unemployed and other people who do not pay contributions should be treated for something.

Point 5: Healing the system

The proposed model, combining effective state regulation and private health insurance, would aim to heal the health care system. Citizens would have greater freedom of choice and access to higher quality medical services. The redistribution of people not paying contributions between private insurance companies would ensure that no social group would be left out, and reducing PIT would contribute to greater financial balance for people using private insurance.

Soon, insurance companies would appear - they would say "we reward emergency departments" that admit patients within 15 minutes, sign up with us.


The proposal presented here to combine elements of health care privatization and state regulation would aim to create a more flexible, effective, and at the same time private health care system. Opening up to private insurers, maintaining state regulation of the benefit package, redistributing people who do not pay contributions and lowering PIT would probably contribute to improving the availability, quality and efficiency of health care for all citizens. Implementing this requires good regulation, close cooperation between the public and private sectors and basing everything from the beginning on sound, non-corruption principles. And a tough response to every attempt to degenerate this truly simple system. If properly designed and enforced, very positive results for society as a whole could be achieved within a reasonable time.

5/5 - (1 vote)


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