Parliament's passage of legislation lowering health premiums for entrepreneurs is almost a foregone conclusion. Will they be signed by the president? Here, the matter is already much more complicated and, at the very least, uncertain (as of today, it can be assumed that Andrzej Duda could be persuaded - by his advisors, not by the government - to agree to the elimination of the contribution on the sale of fixed assets and the introduction of a relief for the smallest entrepreneurs, while the provisions that would change the rules for calculating the health contribution for entrepreneurs in the future, from 2026, he will rather veto).
Feature
Małgorzata Solecka
Entrepreneurs relieved, patients anxious...
Published Nov. 25, 2024 08:06
The implementation of election promises could not come at a worse time. There is not a gap but a breach in the NFZ's finances. It can't be any other way, when, as the latest OECD report shows, Poland spends less than 5 percent of GDP on current health expenditures, putting us in one of the last places in all of Europe. We should, as experts and stakeholders stressed during last week's conference organized by the Health Advocates Foundation on the financial situation of the system, talk about increasing and ordering the contribution burden, but certainly not about reducing it for any social group. Reducing the stream of money that goes directly to the National Health Fund means making it increasingly dependent on budget subsidies - and this does not serve the stability and predictability of the entire system. It is already apparent how interventionist the budget is injecting into the Fund, responding to "fires" that break out.
However, the changes, if they come into effect, will bring with them much more serious consequences. The injustice inherent in the system will be exacerbated, because it is not entrepreneurs, but people working on a contract of employment who are the most contribution-burdened professional group. One could say - they have job security for this, a whole package of solutions that the self-employed can only dream about. One could say that, if another wave of pushing employees out to B2B contracts were not on the horizon, to which such solutions as the government proposes provide a solid basis. Looking, for example, at the tragic demographic data, we should - as a state - act in exactly the opposite direction, because it has been known for a long time that it is the guarantees provided by labor laws (plus, of course, a good economic situation) that create the basis for the decision to have a child(ren).
Experts, but also the Left, which is particularly critical of this long-term solution (not to mention the Together party, which has not left a dry thread on the government's ideas), also point out a paradox: in pushing to fulfill the election promise made to entrepreneurs, the government is putting at stake the election promises made by exactly all coalition partners to improve the situation of patients. Even the best reforms (especially since they are by no means a foregone conclusion and their eventual entry into force will have a deferred effect anyway) will fail if the system does not have a solid financial foundation.
