Health care Systems in Europe on the Example of Poland and Germany
Authors: Liliane Jodkowski
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Change of society’s demographic structure (society’s ageing) causes a need to reform a statutory free health care system. New expensive medical technologies, growing costs of treatment as society is getting older and older together with stagnated tendencies in inflows from health fees make it essential to look for changes that should ease finances of the system.
In this paper, some important reforms of German health care system (after 2000) in the context of looking for solutions for a Polish health care system.
The Polish healthcare system is regularly criticised, and evaluated negatively in comparison with other EU countries. The problems are not only difficult access to medical services (long waiting lists, especially to specialists), corruption, providing services out of turn, low earnings in the sector and resulting outflow of highly qualified workforce to countries providing better working conditions and higher salaries, but also low quality of services (meaning high level of complications) and high patient co-payment (medication charges and so-called “expressions of gratitude”). This situation is not affected by changes in Polish demography, but, among others, the gaps in the healthcare system regulations and insufficient supervision over medical units, enabling and facilitating corruption and creation of monopsony (there is only one recipient - NFZ. This concept is especially relevant to the labour market, with only one employer in the region and many dependent employees or, for example, one state company purchasing goods or services from multiple suppliers) in the market of statutory medical services (NFZ).
The German system is also criticized but for different reasons. In particular it is thought to be ineffective in fund management, which results from the system organization and is expressed in relatively low quality of services by relatively high costs.
The aim of this paper is to compare the health care systems in Poland and Germany, to indicate their specific problems and steps taken to adapt these systems to challenges caused by the change in the structure of society and the development of modern technologies as well as the costs increase while maintaining, at the same time, fair access to free health services, reasonable expenditures and ethical principles.