Black "Health Vision": NHF is drowning in costs

Szulc took part in the opening discussion of the conference "Health Vision. Diagnosis and Future," organized by the Termedia publishing house, during which most of the time was devoted to the current financial situation of the health care system and ways to overcome the crisis. The Fund's vice president argued that "everyone should try to take responsibility for what is happening in the Polish health care system."

- The basic premise of the National Health Fund is that it pays for the treatment of the insured from the health premium. This situation has been maintained for many years, albeit with various changes. Systemic solutions appeared, which made the fund also responsible for the treatment of the uninsured, more and more ranges of unlimited services entered, i.e. those for which we are not able to predict what the final volume will be at the end of the year. It is therefore difficult to plan the budget in such a situation," he said, pointing out the reasons for the financial imbalance, resulting from the regulations themselves, because the NHF has to present a balanced financial plan for approval, which, however, in reality cannot be balanced, because many elements on the cost side at the time of creating the plan are not possible to calculate precisely. The result? - Every year, the fund's costs are pruned to the projected revenues, not the other way around - that's why we have an imbalance," explained Jakub Szulc, adding that the imbalance, which the NFZ somehow managed to cope with, was significantly exacerbated three years ago with the full participation of two factors, namely the November 2022 amendment to the Law on the Profession of Physician and Dentist, which transferred the lion's share of tasks previously financed from the state budget to the NFZ, i.e., for example, highly specialized services, the cost of purchasing vaccines, emergency medical service tasks. In turn, the law on how to determine the minimum salaries of certain medical professions caused an exponential increase in costs on the NFZ side without securing revenues, the vice president explained.

He also stated that the law has served its purpose, as health care salaries are at a good level. On the other hand, from the perspective of the NFZ, it has caused a "logarithmic increase in costs and this increase in costs is causing all the time." As he recalled, the implementation of the increase law this year alone is costing the NFZ budget PLN 58 billion against a budget of just over PLN 200 billion.

Talks are currently underway between the health and finance ministries on additional funds for the National Health Fund: according to payer estimates, the gap this year is PLN 14 billion. Finance Minister Andrzej Domanski said in recent days that the Fund would receive another subsidy, but did not say in what amount. It is also known that another thread in the conversation between the ministries is the issue of changes to the law on minimum wages in health care.