The Czech government has taken an important step in helping the country's troubled health insurers, including the largest Vseobecna Zdravotni Pojistovna, the VZP, by ordering the state consolidation agency to take over three billion crowns of bad debts. Insurers, including the VZP, are in need of the financial support to be able to pay out their claims on time - after being caught in a vicious cycle. Each year they miss billions of crowns owed by Czech firms and members of the public chronically neglecting to pay...
It is an unenviable position for the country's health insurance companies, especially the largest, Vseobecna Zdravotni Pojistovna - the VZP - haemorrhaging from a lack of funds while having to pay out billions to hospitals and other health facilities. Health insurers like the VZP have, for years, been unable to reel in chronic late or non-payers, leading to the lack of funds. VZP spokesman Jiri Suttner:
"It's important to say that the VZP is in a situation where it has no choice but to slow down payments it owes to health facilities. The reason is that we ourselves are owed a total of 17 billion crowns in unpaid debts from non-payers. If the situation were different, if we had those funds, we would never find ourselves in this situation".
While the government's latest move will certainly help - especially the VZP with more than 2.3 billion in bad debts - it is also only a temporary reprieve, good only till the end of the year. What are really required now are comprehensive reforms planned for January 2004. Reforms that Jiri Suttner thinks should include several VZP recommendations made earlier this year.
"We divided the problem into two parts - revenue and cost. As far as revenue is concerned for insurance companies, at least for the VZP, we think it is absolutely necessary to introduce full-scale redistribution of insurance paid by all clients among the health insurance companies, according to the relative costs depending on different age and gender groups. It is no secret that the vast majority of old people are registered with the VZP. That means while the state pays 460 crowns a month for each of them, we have to pay six times more for their health care."
Exactly which steps the Health Ministry will adopt in 2004 remains a question for now, though it is clear they will have to be complex and all-encompassing, bringing an end to the kind of haemorrhaging in funds we have seen in the VZP and smaller health insurance firms.
Additional reforms could also end-up including legal levers making it easier for health insurance companies to squeeze non-payers, helping quash an attitude Mr Suttner says many businesses and businessmen have held till now: that it is okay to try and pull a fast one on the state - and by extension health insurance companies. That, he says, is an attitude that ends up hurting everybody, since at one time or another, all of us have to rely on health insurance for our well-being.
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