Dispute over PLN 4 billion from the Medical Fund. Government draft after first reading

The government's draft has two main goals: to allow the Medical Fund to transfer PLN 3.6 billion to the NFZ for unlimited services for children and adolescents, and to sanction that the PLN 4 billion that Izabela Leszczyna transferred from part 46 of the state budget to the NFZ, although she should transfer the subsidy to the FM, will not be "due." This is the main axis of the dispute between the government and the president - and this is what the plan to save the NFZ's finances may come crashing down over.

Presenting the draft, Deputy Minister Katarzyna Kacperczyk explained that the amendment is primarily aimed at allowing an increase in the amount of Medical Fund resources allocated in 2025 for the cost of healthcare services provided to children. She recalled that in 2024 the National Health Fund additionally financed from health insurance premiums the so-called over-limit services provided to children in the amount of PLN 2 billion 397 million and 574 thousand, which were not reimbursed from the Medical Fund. - The limit specified in the Medical Fund Law is significantly underestimated, which means that in fact most of the costs of these services for children are financed from the National Health Insurance Fund's own funds, rather than from the Medical Fund.

- The second element is the adjustment of the maximum and minimum limits of payments planned to be made from the state budget to the Medical Fund to its actual needs in each year. At the same time, these changes are aimed at ensuring its financial liquidity in the perspective from 2026 to 2029. Therefore, it is necessary to adjust the annual payments from the state budget to the Medical Fund in this particular period accordingly, she added. In the draft, the government stipulated that from 2026 the budget subsidy to the FM will be higher than the minimum specified in the law, i.e. PLN 4 billion.

- This is a bill for Ms. Hazel to get a card, like in "Monopoly," to get out of jail free of charge. Because she took 4 billion from part 46, because she didn't get enough money for health care. And it's the fault of the prime minister and finance minister that she didn't get them," pointed out Janusz Cieszynski (Law and Justice). President Karol Nawrocki announces that he will not agree to "write off" this "loan."

Marcelina Zawisza (Together) also did not spare the government. - That there will be a shortage of funds in the health care system, you have known since last November, if not October. This could have been done earlier and prevented people from simply bouncing out of hospitals, having postponed procedures, surgeries, and simply not knowing if their planned procedures will take place," she said. Zawisza also stressed that the lack of a decision to proceed with the president's draft means nothing less than the threat of a veto, and if this scenario comes true, the full responsibility will fall on those in power, who put their pride above patient safety.

Members of the ruling coalition reminded that the previous government was to blame for the financial imbalance of the health care system. - It was you who introduced an automatic salary increase in 2022, and that is why there is such a hole now in the NFZ. You shifted the costs of emergency medical services and free medicine onto the shoulders of the NFZ. You also have to admit that during the pandemic, planned treatments were postponed, savings were created in the fund, which you made all of them more than in 2023 according to the principle "after us though the flood," and you ended the year with a loss in the NFZ of 16 billion zlotys," recalled Elzbieta Polak (KO).

- The 3.5 billion zlotys that will be credited to the NFZ will perhaps be enough to complete payments for the second quarter, perhaps to supplement the value of contracts in Mazovia and Silesia. However, I will remind you that neither the second nor the third quarter of this year ends. What you are dealing with today is necessary to implement, while this is symptomatic treatment. The National Health Fund needs 10 billion zlotys by the end of the year," said Wojciech Wisniewski of the Federation of Polish Entrepreneurs.

After discussion, voting on a number of amendments, including the establishment of safety and rare diseases in children subfunds within the Medical Fund (which are included in the presidential draft), the government draft was approved with 15 votes in favor and nine abstentions. The second reading is scheduled for Thursday evening.