Immediately after the vacations, a bill on changes to the contribution from entrepreneurs is expected to reach the Sejm. Finance Minister Andrzej Domanski has already announced, in a framework, what might happen: the obligation to pay premiums on the sale of fixed assets (repeatedly cited, for example, cars) will disappear. Will the Third Way, which would like a much larger scale of relief for entrepreneurs, agree to such a compromise, which means a loss of "only" PLN 4 billion from NFZ revenues, when it has been advocated - in an extreme variant - to withdraw all the changes introduced in the Polish Deal, which would cost more than PLN 10 billion?
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Malgorzata Solecka: Familiar melodies do we like best?
Published July 29, 2024 17:02
One may be surprised that politicians are bringing up the subject of reducing the NFZ's premium income at all, at a time when all signs in heaven and earth not only indicate, but prove, that the payer's shaky financial balance is a thing of the past and tensions, caused by low funding levels, will only get worse? Problems with settling payments for overtime and non-limited services in the first quarter, the cancellation of the allowance for the general reserve in 2024, announcements - unofficial for the time being - that in subsequent quarters hospitals must expect a reduction in funding for overtime in the area of limited (and lump-sum) services... This does not sound optimistic.
Politicians explain that the revenues of the NFZ will not fall, because they will be compensated by a higher subsidy from the state budget - just as if they believed that the money in the budget is provided by a factory in the North Pole, and as if they did not register that Poland has been placed under the excessive deficit procedure, which directly means the need to seek savings in the public finance system.
Of course, not all politicians want to move in this direction. The Left is proposing to do the opposite, to increase revenues for the health system by replacing the health premium with a 9% tax. The difference is not just in name, because it means broadening the base, both subject and object, of revenue sources and translates, as Deputy Health Minister Wojciech Konieczny calculated in recent days, an additional minimum of PLN 32 billion for the system. And - this is another benefit - simplifying health care financing. To this end, argues the Left, the health premium and insurance (contribution) system must disappear, replaced by financing from the state budget.
The familiar tunes we like best? We listened to them in 2005-2007 and 2015-2017, when Law and Justice was in power (incidentally, this is one of the amazing examples of the closeness of the ideas sitting in the heads of the leaders of the two parties, so different in the ideological sphere and so almost twinned in the sphere of at least social policies). But one should not dismiss everything that the Left "sings" about the health premium - a few months ago, experts made recommendations for changes in health care financing, and one of them was precisely to simplify the rules for calculating the health premium. Of course, not by abolishing it, but - changes in the base, i.e. unifying the basis for calculating premiums for all insurances, which would also bring multibillion-dollar profits to the payer. The Left's demands are also consistent with another recommendation - we must strive to make the health premium payable by all (or perhaps not so much "by" as "for") who use the public health care system.
