The Breakdown of the Polish Health System

A lot can be said against the previous system, but their record when it comes to providing health services to the people, compared to the current one, is immaculate. I remember friends from the US gaping with mouth open when they learned that not only the health care was free, but all medicine was subsidized. “You mean that taking out an appendix wont cost you a cent, even though you don’t have a private health insurance?” they would ask, and I would retort, perhaps a bit naively: “private, what?”. (Obviously, I could not imagine a system where a hospital could refuse treatment of a patient in need, simply for pecuniary reasons).

Being a doctor in Poland was not a proper way to become a new Rockefeller, if that was your goal. On the other hand, people in the profession were almost exclusively those that felt the call to help their fellow human being, rather than looking for a lucrative profession. As if free health service was not enough, the state provided free of charge - for a symbolic fee - sanatoria and health homes. No doubt, Poland was a veritable paradise for the sick.

And then the change of regime came. And as always: you win some, you lose some. The Poles won their “freedom”, but in return - after forty five years of taking it for granted - lost their unique health system, which takes some time getting used to.

In the aftermath of the take-over in 1989 all of a sudden the state noticed the bottom in the treasury chest. Hey, better start saving, before it’ll be too late. We might be declaring bankruptcy soon, the government warned – and started to cut. And what do you cut first? The usual - the public sector has to go under the scalpel. Where do we cut? “Cut where it hurts”, said the minister of finance. He amended himself, “I mean, where we can save the most, without jeopardizing the system.”

The minister of education said, “I propose that the health system takes the cuts,” unaware that his department was next to go under the knife, and everybody applauded, except the health minister.

Said and done. Welcome to the new Polish reality. As a result of budget cuts for the last sixteen years, the Polish health system had make do with less and less. Already old-fashioned hospitals with their old-fashioned equipment had to manage with the rests from the finance ministers table.

Suddenly the good doctors started to charge real fees for their services. The hospitals, short of beds, started to treat only those in very real needs, and unless you were close to dying, only a contribution to the doctor’s or nurse’s welfare could get you a hospital bed.

The additional beds in the hallways, many patients sharing a single room, is a common sight. There is also a shortage of most anything, pills, blankets, chairs, medical equipment, medicines… you name it - even soap is in short supply.

And if this was not enough, the Polish doctors and nurses noticed new, tempting opportunities. Since Poland’s arrival into the EU, many countries actively pursue Polish health personnel, offering very attractive salaries. No wonder so few can say no.

The overall outcome for the Polish nation is not very palatable. There is already a shortage of trained Polish personnel - the gaps filling slowly with the doctors from other – non-EU countries. Thus, you should not be surprised if you need a Polish- Russian, White-Russian or Ukrainian lexicon in order to communicate with your doctor. It can be even worse if you happen to meet a doctor from Rumania, India or Ethiopia. Although, it can be possible to find a Polish-Rumanian lexicon, it is much harder to find an Ethiopian one. Not only do they speak Amharic, you need also to learn a different alphabet to use the lexicon, if you can find it at all.

The queues to see a GP or a specialist grow daily. Thus, if you are a patient in Poland, you’d better look up the true meaning of the word in a lexicon. You will need a lot of patience waiting to see your doctor, if he is still at his surgery, rather than in the UK.

Only this year, according to the Polish Medical Council, thousand of dentists and doctors have left the country, and many more are to follow. This is just one of the unexpected blessings of the open labor market. There are so many offers from abroad that the poor doctors have a serious problem to choose between them. No wonder the doctors are happy but not the Council. The cost of training a doctor is several million PLN and takes years, says their spokesman and adds. “Everyone takes off: newly examined and experienced, it is a veritable exodus.”

The most notorious countries causing this brain-drain are the UK, Ireland, Sweden, Germany and Denmark, seeing it as a quick and dirty solution to their own shortage of health personnel. This is simply the old imperialism in a new form, draining the resources from a poorer country. And the doctors can’t say no: the temptations are simply too many: not only the paycheck is fatter, accommodation, even language courses, are provided free of charge. And the fact that the doctor’s pay in Poland Is low, between 1500-2500 PLN, makes it an easy decision if offered a payment ten times higher.

The reasons why more doctors don’t move to the West vary, since most do not have competency in the foreign language, some fear living in a foreign country, leaving the family behind. If more doctors move, the situation might become serious, because Poland already has a shortage of doctors, only 20 per ten thousand inhabitants, which is less than half compared to countries like Italy to Spain.

Only the UK has a lower number of doctor' per capita (14 per 10,000) – no wonder this is where most of the Polish doctors move.

It seems that Poland will have to swallow a bitter medicine, a reward for the free EU access, by continuing to train doctors for the benefit of other EU countries, and thus indirectly subsidizing the foreign health education.

Not according to the OECD statistics - according to which in 2003

Poland had 25, UK had 22.. and i.e. Finland had 24 doctors per 10.000 citizens:

oecd.org/dataoecd/59/47/35529872.xls

I`m not going to say that the healthcare here is great - cose it isn`t - but statements like these:


are a total exaggeration, cose you`ve forgot to mention that about 1/2 of the healthcare is being run by the private sector - and most doctors beside working in public clinics and hospitals are working also in their own private clinics. The extra services offered by hospitals are also being charged extra - and this caouses that most hospitals work as public-private enterprises. Those shortages you`re mentioning do accour - in some of the hospitals in the province, some provincional hospitals are being closed becaouse of lack of money - and new - private ones are being opened.

Besides, as you can see Poland has one of the highest numbers of hospital beds in wgole Europe:

oecd.org/dataoecd/59/45/35529995.xls

And this brain drain that you`re describing - in case of the doctors (not nurses) in many cases looks this way that - during the week those doctors who are working abroad - are woriking in Poland in their private clinics and public hospitals.. and during the weekend or a specific day during the week, they just koop into a plane to Sweden, UK or whatever they are needed in Europe - and they preform operations and treat their patients there - and then they are returning here to their daily work.

...

In my opinion the whole healthcare system ought to be privatized - cose only this way people would actually recive what they are paying for - and the money wouldn`t be wasted by ZUS for tennis courts for their employees.

I would agree if we lived in a Perfect World. But I lived through both systems and believe me - the private healthcare system completely misses the point. Here is the procedure:

1. You are very ill and go to a hospital. You don't have a health insurance (in the US 50% of people don't have one because they are too darn expensive). The doctors in the hospital operate you and they bill you $1,000 per day just for staying in the hospital + several thousands dollars just for the operation.

2. Since you don't have the insurance, the hospital allows you to pay in installments - let's say $30-$100 a month for the next 30 years. But at the same time their "cost" of you - according to them - is about 80% HIGHER than the patient with the insurance would have to pay (since the insurance will only pay the minimum and RELEVANT cost).

So they steal the money from patients who cannot afford their own healthcare insurance. I don't like this system - it's a ripoff - because they do not charge the patient for the particular treatment -- instad they charge you for all other patients who hadn't paid them in the past and the government is cool with that. This is sick.

Ofcourse - there is no perfect system, however I find that a privatized healthcare is the best solution cose, right now the pay of all Polish citizens is being reduced by a healthcare "tax" independant from the fact if someones sick or not - as well as independant if someone`s using the public healthcare system or not. The that money is being redistributed by various state agencies who in a large part use that money to fund their beaourocratic aparatus, to build new office buildings and to pay vacations for their employees.

I think it would be better to leave that money in peoples pockets - and let the people to decide on what doctor and what treatment they want to spend their hard earned money - when they are indeed in need of medical treatment..

..and state subsidies ought to be spent only to finance a minimal healthcare for those who recive the minimal pay and less.

I also agree that the money should be spent on treatment - not on beaucracy. But the idea of having one major/national "health organization" (protected by the government) in a particular country would lead to the same problems - MONOPOLY . When there's a monopoly, the money is just wasted. So there should be many INDEPENDENT providers with equal rights to do "business" - just like there are so many competing store brands.

People who cannot afford to go to Marshall Fields can go to Walmart - and they will basically get the same product/service but for different kind of money (some people like to overpay but that's another story ; ).

More than 5,000 doctors have either emigrated from Poland or are in the process of leaving their native country since it became an EU member state, DPA cited on Friday a report in the Gazeta Wyborcza newspaper (in Polish).

Gazeta Wyborcza is a newspaper that hardly deserves the honor of being used as toilet paper.

Do you want me to make a list of all of the cases in which it had manipulated the public opinion by writing halftruths and made up stories to support political parties like SLD or PO ?

I'm not good at politics -- I guess let's wait and see if other newspapers pick up this topic and how they relate to it.

If the medical system was to be privatised how would the unemployed or old age pensioners be able to afford hospital cover.

Medical and old age care will be the biggest issue facing all governments in the next 5years.

Medical care should be the responsibility of the government and not be priviatised, nor for that matter public transport/gas and electricity.

Private insurance is out of reach for a lot of people here... having a good public funded system paid by taxes is the only way to go.

wujek you need to research other countries medical systems before talking such rubbish

According to the National Chamber of Medicine around untill now about 4500 allowences to practise medicine abroad for doctors had been issued - so this "more than 5000" is a fairytale.

5000 is c.a. 2% of all doctors in Poland - and as I`ve said previously this only means that those doctors are only allowed to work abroad - which dosn`t mean that they also aren`t working here.

With respect wujek the current health system in poland is tragic, I believe polish doctors are highly qualified and are second to nothing in the world, the current system is much to be desired of, the current system demands that patients in a hospital supply there own sheets and blankets, food, bandages and pay bribes is not good, also the cramped conditions in hospitals is unacceptable.

If polish doctors were to earn more in poland, who would cover the costs?

the sad facts are that poland wants to be identifed as a western type system but are unable to produce the goods in effectively providing similar services as provided by other westen countries.

What is the cost of private health insurance in poland please?

Well, the only sad fact here is that you`re a moron.

Please wujek, I do not throw abuse at you, I may be a moron but god made me that way,

I just asked a simple question.. what is the cost of private health insurance in poland?

It`s good that you are at least admiting it - however - no - you didn`t asked only about that..

In Poland all litterally all is on the permanently edge of the breakdown. It's a polish little tribute to the chaos of the world :)

"W Polsce nic złego ani dobrego nie dzieje się do końca - "In Poland nothing (good or bad) can reach the end" (translating is very badly, maybe someone could do it right:)