ESPN Thematic Report on Inequalities in Access to Healthcare - Czech Republic (European Social Policy Network)
| Autoři | |
|---|---|
| Rok publikování | 2018 |
| Druh | Účelové publikace |
| Fakulta / Pracoviště MU | |
| Citace | |
| Popis | From the very beginning of healthcare transformation in the early 1990s, there has been a clear focus on maintaining broad and generous access to medical care for Czech citizens. The Constitution guarantees free access to healthcare on the basis of statutory public health insurance. Coverage is virtually universal, and the range of the benefits available to insured individuals is extensive. In principle, insured individuals are entitled to any medical care intended to maintain or improve their health status; in practice, there are certain limitations (e.g. cosmetic surgery, dental prostheses, etc. are excluded). The Eurostat data on self-reported unmet need for medical treatment show the Czech Republic in quite a good light: the 95.7% level of ‘no unmet needs to declare’ in the total population aged 16 and over is equal to the EU average for 2016. However, the availability of care is currently being challenged. The lack of healthcare staff in specific areas and the relatively high average age of healthcare professionals are factors that are starting to hinder the functioning of the healthcare system. There are shortages of certain specialists and staff in general in rural areas. The availability of health services was partly enhanced in 2012, when the government introduced explicit guidelines on their accessibility in terms of time and place. However, long waiting times remain an issue, not only because of the lack of personnel, but also because of regional disparities in the availability of expensive medical equipment. Out-of-pocket (OOP) payments represented nearly 14% of total expenditure in 2015. Measured as a percentage of final household expenditure, this places the Czech Republic in the group of EU countries with the lowest level of OOP spending (OECD, 2016)). Affordability of care is good. However, the burden of OOP payments can be significant for some population groups, such as elderly people. The government’s policy reflects that fact and several policy measures have been introduced to protect the most vulnerable groups. Generally speaking, inequalities in access to healthcare are not usually considered to be among the most challenging issues facing the current Czech system. The system ensures a relatively high level of financial protection and affordability. In our opinion, the main weaknesses relate to lack of transparency: the system does not promote transparent waiting lists, and there is a general culture of informal, mutually beneficial relations overall in the country. There are some serious challenges, such as a lack of healthcare staff in certain areas and the relatively high average age of healthcare professionals. There is one vulnerable population group for whom affordability and availability of care can be problematic – the elderly, and especially those in the lower income deciles and/or who are chronically ill. A study conducted by the European Union Agency for Fundamental Rights (FRA, 2013) also mentions Roma and immigrants in this respect. This may well be true; however, there are insufficient data to assess the extent of such inequalities or discrimination. |