156th mBank-CASE Seminar Proceedings:
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Alicja Domagała
Articles from this author:
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169th mBank-CASE Seminar Proceedings: An outline of needed reforms for the healthcare system: What has the COVID-19 crisis changed?
Limitations on the efficient management of healthcare and on effective management in health facilities have been a constant problem in Poland for about 20 years. The Covid-19 pandemic has uncovered all of the shortcomings of healthcare in Poland, which had consistently been being brought up in expert works and the public debate. Our report on the healthcare interventions that are essential today – at the peak of the Covid-19 epidemic in Poland – is the fruit of presentations and discussions at the mBank-CASE Seminar held on April 15, 2021. Thus far, reform programs haven’t been comprehensive, and even those based on accurate and comprehensive diagnoses of the situation haven’t had a lot of power to enact change. The CASE Foundation has also undertaken work indicating the main causes of healthcare’s ailments and outlining the threats to Poles’ health. Previously, it had analyzed the ineffectiveness of the system after the 1999 reform. Much attention was paid to the dangerous lack of medical and care staff, factoring in the aging population with growing medical and care needs in developing forecasts. Alongside the currently constant theme of underfinancing the healthcare system, much attention has been paid in recent years to the subjects of weak governance; the lack of the necessary information to diagnose problems; the lack of planning, reporting and evaluation procedures; and insufficient dialog with both the public and healthcare workers, resulting in burdensome strikes by nurses, residents, anesthesiologists, and physical therapists. Attention has been drawn to the managerial incompetence of political leaders in the healthcare system, regardless of their occasionally very high medical qualifications. The Covid-19 pandemic has uncovered all of the shortcomings of healthcare in Poland, which had consistently been being brought up in expert works and the public debate. Our report on the healthcare interventions that are essential today – at the peak of the Covid-19 epidemic in Poland – is the fruit of presentations and discussions at the mBank-CASE Seminar held on April 15, 2021 (video: Kierunki niezbędnych reform w ochronie zdrowia - Bankier.pl) They address all the subjects raised at the mBank-CASE seminar in 2018: 1) the need for increased outlays on healthcare, along with more effective allocation; 2) the need for urgent investment in developing medical staff resources; 3) introducing transparent and socially acceptable rules for individual co-payments and 4) efficient public management (governance) of the healthcare system (see Golinowska et al, 2018). Additionally, it introduces the theme of organizing healthcare in relation to the dilemmas of the decentralization and autonomy of the main management entities and facilities that provide healthcare. It also raises the problem of public health and the consequences of neglecting this constantly underappreciated area of healthcare. Each of these subjects requires an explanatory introduction of the categories applied and of more general relevant principles (and theories) which will make it easier to understand our recommendations.
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169th mBank-CASE Seminar Proceedings: An outline of needed reforms for the healthcare system: What has the COVID-19 crisis changed?
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CHRISTOPH SOWADA
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Krzysztof Kuszewski
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Marzena Tambor
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Stanislawa Golinowska
Professor of Economics, specialist in social policy, labour market, health economics and public health.
Articles from this author:
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169th mBank-CASE Seminar Proceedings: An outline of needed reforms for the healthcare system: What has the COVID-19 crisis changed?
Limitations on the efficient management of healthcare and on effective management in health facilities have been a constant problem in Poland for about 20 years. The Covid-19 pandemic has uncovered all of the shortcomings of healthcare in Poland, which had consistently been being brought up in expert works and the public debate. Our report on the healthcare interventions that are essential today – at the peak of the Covid-19 epidemic in Poland – is the fruit of presentations and discussions at the mBank-CASE Seminar held on April 15, 2021. Thus far, reform programs haven’t been comprehensive, and even those based on accurate and comprehensive diagnoses of the situation haven’t had a lot of power to enact change. The CASE Foundation has also undertaken work indicating the main causes of healthcare’s ailments and outlining the threats to Poles’ health. Previously, it had analyzed the ineffectiveness of the system after the 1999 reform. Much attention was paid to the dangerous lack of medical and care staff, factoring in the aging population with growing medical and care needs in developing forecasts. Alongside the currently constant theme of underfinancing the healthcare system, much attention has been paid in recent years to the subjects of weak governance; the lack of the necessary information to diagnose problems; the lack of planning, reporting and evaluation procedures; and insufficient dialog with both the public and healthcare workers, resulting in burdensome strikes by nurses, residents, anesthesiologists, and physical therapists. Attention has been drawn to the managerial incompetence of political leaders in the healthcare system, regardless of their occasionally very high medical qualifications. The Covid-19 pandemic has uncovered all of the shortcomings of healthcare in Poland, which had consistently been being brought up in expert works and the public debate. Our report on the healthcare interventions that are essential today – at the peak of the Covid-19 epidemic in Poland – is the fruit of presentations and discussions at the mBank-CASE Seminar held on April 15, 2021 (video: Kierunki niezbędnych reform w ochronie zdrowia - Bankier.pl) They address all the subjects raised at the mBank-CASE seminar in 2018: 1) the need for increased outlays on healthcare, along with more effective allocation; 2) the need for urgent investment in developing medical staff resources; 3) introducing transparent and socially acceptable rules for individual co-payments and 4) efficient public management (governance) of the healthcare system (see Golinowska et al, 2018). Additionally, it introduces the theme of organizing healthcare in relation to the dilemmas of the decentralization and autonomy of the main management entities and facilities that provide healthcare. It also raises the problem of public health and the consequences of neglecting this constantly underappreciated area of healthcare. Each of these subjects requires an explanatory introduction of the categories applied and of more general relevant principles (and theories) which will make it easier to understand our recommendations.
- Unregistered Work: Causes and Consequences.
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Main conclusions and supplementation to the CASE Report: “Our Europe: 15 years of Poland in the European Union”
The presented text, designed as an Executive Summary of the “Our Europe. 15 years of Poland in the European Union” report, differs from the classic form of a summary. On one hand, it adds a lot of contextual historical and institutional information which functions as an introduction to the solutions presented in the following chapters. … Continued
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169th mBank-CASE Seminar Proceedings: An outline of needed reforms for the healthcare system: What has the COVID-19 crisis changed?
What’s next
for healthcare in Poland:
diagnosis and prognosis
The health protection system is the object of constant pressures and difficulties in mitigating them, and even more so eliminating or at least reducing them. Changes are undertaken under the influence of a one-sided political assessment, the interests of various groups of participants or the protests of successive groups of medical staff. There is no professional and fully documented diagnosis of the system, made by independent experts, which could serve as the basis for a comprehensive health protection reform plan, rather than individual, incidental changes that disrupt the system’s already very fragile balance. A well thought-out reform, properly distributed over time, so that at no point does it cause negative health effects. A reform agreed among stake-holders and adopted with understanding of the need for changes, so that it is supported by society. A reform for which there will be funds, institutions and engaged professionals – leaders in health protection. A reform that won’t be criticized or changed when the government changes. Such a reform is waiting to be presented and debated. We begin this process by pointing out and presenting the system’s main problems. At the top of the list of issues that must be taken up urgently we place the problem of insufficient resources, but associated with other activities that are essential to achieve higher effectiveness in accomplishing health goals. There is no single miraculous way of balancing and fixing the functioning of the health protection system. This requires both greater financing, qualitatively and quantitatively appropriate staffing, and good institutions. Financial resources are a necessary condition but not a sufficient one – if there is no staff or appropriate institutions, and these are shaped over years.
In this publication we present four subjects, corresponding to that list of the main issues that must be addressed urgently. We begin with the problem of good governance, meaning achieving a decisive improvement in institutional solutions in health protection. Next we take up the problem of the need for growth in financial outlays, with judicious public and individual responsibility. We strongly accent the need for development in Poland of medical and support staff, presenting the problems of neglect and the deep shortage of professionals, which is currently paralyzing the health service. The final text, though no less important in the group of priority problems in health protection, concerns public health and demands that it be properly valued by treating care for the health of the population as an investment in human capital with a measurable and significant rate of return.