Czech Health Care Reform: The Way Forward

The Czech Republic's health care system has been completely overhauled, replacing the nationalized system with a scheme which in theory emphasizes privatization, decentralization and competition but which actually works more pragmatically, and with only some reforms yet installed. As a result, the system is now at a crossroads, Ulrich Hoffmeyer, pharmacoeconomic scientist with Glaxo Wellcome R&D Ltd in the UK, and former senior consultant with National Economic Research Associates, told the biennual Assembly of the International Federation of Pharmaeutical Manufacturers Associations in Vienna, Austria, last month.

There are two choices, he said; either a step backwards towards centralization and national regulation, or further moves towards implementing the original reform ideas, with proper regulation to encourage their success. A study of the Czech system, conducted by NERA and sponsored by Pharmaceutical Partners for Better Health Care recommends that the second choice be adopted, with further decentralization and more competition, he said.

Swiss Or Singapore Options The study recommends that health service financing be dealt with first, and proposes two options. One, the Singapore Option, revolves around the idea of Medical Savings Accounts, while the second, the Switzerland Option, is based on competing insurance funds. While it does not favor one option over the other, NERA believes the first to be risky and unpredictable, largely because MSAs are untested outside Singapore, while it feels the second, more traditional option could be implemented with less disruption and find easier acceptance with the Czech people.