The Process of Privatization of Health Care Provision in Poland

Krzysztof Kaczmarek; Hannah Flynn; Edyta Letka-Paralusz; Krzysztof Krajewski-Siuda; Christian A Gericke

doi:10.1016/j.vhri.2013.06.001

The Process of Privatization of Health Care Provision in Poland

Value Health Reg Issues. 2013 Sep-Oct;2(2):306-311. doi: 10.1016/j.vhri.2013.06.001. Epub 2013 Jul 25.

Authors

Krzysztof Kaczmarek¹, Hannah Flynn², Edyta Letka-Paralusz³, Krzysztof Krajewski-Siuda⁴, Christian A Gericke⁵

Affiliations

¹ Department of Health Policy, Medical University of Silesia, Katowice, Poland.
² PenCLAHRC, National Institute for Health Research, Plymouth University Schools of Medicine and Dentistry, Plymouth, UK.
³ Department of Public Health, Medical University of Silesia, Katowice, Poland.
⁴ Sobieski Institute, Warsaw, Poland; University of Information Technology and Management, Rzeszow, Poland.
⁵ The Wesley Research Institute, Brisbane, Australia; University of Queensland School of Population Health, Brisbane, Australia; Queensland University of Technology School of Public Health, Brisbane, Australia. Electronic address: cgericke@wesleyresearch.com.au.

PMID: 29702882
DOI: 10.1016/j.vhri.2013.06.001

Abstract

Objectives: In January 1999, a new institutional structure for Poland's health care system was laid out, instigated by the dramatic change in both the political and economic system. Following the dissolution of state socialism, private financing of health care services was encouraged to fill an important role in meeting rising consumer demand and to encourage a more efficient use of resources through competition and private initiative. However, from the outset of the intended transformations, systemic limitations to the privatization process hindered progression, resulting in varying rates of privatization amongst the distinct health care sectors. The aim of this paper is to describe the privatization process and to analyze its pace and differences in strategic approach in all major health care sectors.

Methods: Policy analysis of legislation, government directives, and published national and international scientific literature on Polish health reforms between 1999 and 2012 was conducted.

Results: The analysis demonstrates a clear disparity in privatization rates in different sectors. The pharmaceutical industry is fully privatized in 2012, and the ambulatory and dental sectors both systematically increased their private market shares to around 70% of all services provided. However, despite a steady increase in the number of private hospitals in Poland since 1999, their overall role in the health care system is comparatively limited.

Conclusions: Unclear legal regulations have resulted in a gray area between public and private health care, where informal payments impede the intended function of the system. If left unchanged, official health care in Poland is likely to become an increasingly residual service for the worst-off population segments that are unable to afford the legal private sector or the informal payments which guarantee a higher quality service in the public sector.

Keywords: Poland; health care provision; health care reform; health policy; privatization.