Problems in the Czech health care sector have been discussed for years. The sector, currently headed by the 12th minister in just 16 years, has been plagued by a chronic lack of finances, resulting in late payments to doctors from indebted health insurance companies, among other things. Experts are now raising their voices that such an unstable environment is fertile soil for corruption.
Last week, an investigative programme on a commercial TV channel revealed a case of what appears to be widespread practice in the Czech health care system. A hidden camera recorded a bribe of around 850 dollars changing hands between a patient and a surgeon. In return the doctor promised to move the patient up a waiting list for a hip replacement operation. Dr Pavel Hrobon works for the not-for-profit organization Health Reform.cz. He says bribery is just one type of corruption in the Czech health care sector.
"There are two types. One type I would call institutional corruption which is corruption in the relationships between institutions: between health care providers and health insurers, between providers and suppliers of technology, drugs etc. The second area of corruption is corruption on the patient-health system level which was very widespread in the time of communism. Since then it almost disappeared because this corruption is very susceptible to the accessibility of services. If services are accessible there is basically no reason for this corruption. As soon as the services become less accessible, which is happening just in these months, the level of corruption will go up again."
Pavel Horak is the director of one of Prague's major state-run hospitals.
"The system makes a false impression that everything is free and available, which, of course, it is not. If a patient wants some special services, such as a second opinion on his/her diagnosis, there is no official way to get it and pay for it. So the patients who know how to take advantage of the chaos will find a way of getting that extra service, either by simply relying on the health insurer to cover everything or by bribing someone."
The Czech branch of the corruption watchdog Transparency International is aware of the situation. The organisation's director Adriana Krnacova says the level of corruption in this country is quite high in general and the health care is no exception. But she suggests bribery at least could be tackled by a revision of the health insurance system.
"One solution is to look at the system of health insurance and to balance it in a way that there should be a basic, standard health insurance and also a way for patients who are interested to pay more to have this possibility."
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