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The Warsaw Voice » Business » October 1, 2010
Business & Economy
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Patients Need a Trusted Doctor
October 1, 2010   
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Małgorzata Kowalska, Vice-President of the board of private health services provider Medicover in Poland, Managing Director, talks to Bożenna Osucha.

What do you think of the government’s proposed changes to the healthcare system?
We still don’t know enough about the specifics. What is obvious, though, is that changes to the healthcare system have become the government’s current priority. This is a good thing, the only question being how deep the changes will be and how long it will take to introduce them. The constitution guarantees two fundamental rights in Poland: the right to healthcare and the right to equal access to financial benefits from public funds. So far, implementation of both these provisions leaves a lot to be desired. Over the last 20 years of economic and political transformation, no comprehensive regulation of the health services market has been accomplished. Perhaps we have finally arrived at a moment when at least some of the key reforms will be carried out. Whether this will really be the case, it’s hard to say. A lot depends on how determined the government is.

What changes are most urgently needed from the point of view of a private healthcare provider and a private investor?
There are several things. One is applying the principle of equality of treatment of all healthcare providers and preventing anything that aims to restrict competition among private and public providers. What I mean by this is equal access to public funding for healthcare services, but also, a less widely discussed issue, equal access to EU funding.

Equal treatment is an issue you have raised often, and you have also appealed for rules that would guarantee contracts for private investors. Why is this so important?
Because today investors pumping tens of millions of euros into this tough market have no guarantees that after building a hospital or even a hospital chain, they will be able to sign a contract with a public body. The problem is not the goodwill of the National Health Fund (NFZ), as this is not lacking. It is about legal regulations that do not allow a promise of a contract to be issued. In effect, many private investors decide against serious investments precisely because of the financial risk involved. Meanwhile, the main beneficiary of such investment is Polish patients, who are waiting for advanced medical infrastructure.

What form would you like to see the healthcare funding system take?
Besides being comprehensible to all those involved, it should be reliable and long-lasting, and that means it cannot keep being changed, because a legislative seesaw is not conducive to long-term planning. It also has to be fair, that is, based on the principle of equality. Developing such a system requires close cooperation with the NFZ, the Ministry of Health and, first and foremost, with legislators.

What other changes are needed?
A new law on extra, voluntary health insurance is essential. This would be an additional source of funding for the healthcare system in Poland. Though insurance companies are already trying to develop this form of insurance, without incentives from legislators this development is far too slow. The main issues here are CIT, PIT and VAT tax exemptions for entrepreneurs in the healthcare sector. Without this, it is hard to imagine any rapid development of the health insurance market in Poland.
Yet Medicover has been investing in this market. Last year you built first hospital offering a full range of treatment in Warsaw’s Wilanów district...
That’s true. The position Medicover has built up while refusing to be put off by various limitations is mainly the result of years of determination in creating an alternative system of health services. Of course if the barriers were fewer, the development of companies like Medicover could be even more dynamic. But we have nothing to complain about.

Does Poland really need a private hospital offering a full range of treatment? How does this differ from smaller facilities?
The market, especially in Warsaw, has room for small, one-day surgery facilities and a private multi-profile hospital. There are several differences, though, important ones that we need to speak about loudly since not everyone is aware of them. Compared to one-day surgery clinics, which mainly perform surgical operations and procedures, a multi-profile hospital can also accept patients requiring longer-term treatment, where the medical risk can be very high and complete diagnostics and multifaceted treatment may be required. This applies to fields such as pediatrics, internal medicine and cardiology.

The differences must be visible when a patient has complications...
That’s true. With one-day surgery clinics, when more serious complications occur during treatment, requiring specialist hospitalization and sometimes even intensive care, it may become necessary to transport a patient to a public facility. Private multi-profile hospitals don’t have that problem. The facility has an intensive care unit and an intensive cardiac monitoring unit, and its medical staff-the entire spectrum of specialists-is there for patients day and night. One-day surgery is very much needed, but when problems begin, its range of services simply isn’t enough.

What factors you think are the most important in modern-day healthcare, both as an expert and a potential patient? What decides that a given medical program is the best for patients?
That’s a tough question, and the answer has to be on several levels. As a patient, I take notice of whether the care I am given is comprehensive, with modern diagnostics, outpatient and specialist treatment, including hospital care; whether it is available when I really need it; whether it is safe and focuses on my needs. In today’s world, patients take advantage of increasingly advanced medicine, with new possibilities opening up all the time. To negotiate this world effectively, you need a professional adviser—an individual, trusted doctor who will coordinate everything and stay in direct contact with the patient.
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