Parallel worlds

We live in parallel worlds. In the reality created in the conference room of the Ministry of Health, the world appears in brighter and brighter colors. There is more than 160 billion zlotys in the system, when eight years ago there was only 70 billion. - We have doubled health spending," argues Adam Niedzielski, otherwise a doctor of economics. In this reality, it is possible to increase the "extra money" in the system by a billion zlotys in three days - on May 22, the minister, during a meeting of the presidium of the Trilateral Team for Health Care, talks about 14 billion zlotys, only to bump the rate up to 15 billion zlotys on May 25. In this reality, it is also possible to present calculations of "additional money" amounting to PLN 7-7.5 billion by the end of 2023, while the amendment to the NFZ financial plan, reviewed by parliamentary committees, indicates that additional revenues from health premiums and interest on bank deposits will amount to PLN 4.8 billion this year.

Above all, however, it is possible to talk about "additional money", when in the meantime there is and will be no additional money in the system, because only money from health premiums is shared. In addition, the dynamics of the flow of these additional contributions is lower than in previous years - perturbations in the economy are making themselves felt. Experts from the Federation of Polish Entrepreneurs estimate that the additional premium flow provided for in the current amendment to the financial plan exhausts this year's possibilities, and we can't expect any revenue above this plan by the end of the year. At the same time, they stress, in order to fulfill the minister's promises to transfer money to medical entities to finance rising costs, the NFZ will probably be forced to zero out all of its financial reserves, unless there is - as will be known any moment now - some surplus for 2022. A surplus, resulting from underperformance.

The reality as seen from Miodowa Street is one thing, the real world is another. In this world, as Lukasz Kozlowski, chief economist at FPP, reminds us, the increase in money in the health care system is almost exclusively nominal. What's more, while the revision of the Fund's financial plan shows an increase in premiums (small, by about 3 percent), an analysis of all macroeconomic indicators shows that the percentage of health spending relative to GDP will decline. The real one - from the recently assumed 5.11 percent to 5.07 percent (GDP is growing faster than money in health). The one calculated relative to GDP two years ago will also be lower (although it will still oscillate around 6.5 percent). But the problem is not this year, but next year: by the end of May, the Ministry of Finance should provide the Health Ministry and the National Health Fund with a set of data needed to prepare a financial plan for the next year, including information on the amount of the subject subsidy, resulting from the law of 7 percent of GDP for health. According to the roadmap for reaching the 7 percent of GDP level in 2027 (calculated according to the N-2 methodology, of course), the percentage of health spending should be a minimum of 6.2 percent of GDP. - For this to be possible, a subsidy of about PLN 11 billion will be necessary, looking at currently available macroeconomic indicators, the FPP expert argued on May 24 during the presentation of the latest edition of the Health Care Financing Monitor.

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