Zmiana społeczna w ochronie zdrowia w Polsce - czyli: o reformie jakiej potrzebujemy

• Autorzy: Romuald Holly

Warianty tytułu

A Social Change in the Scope of Health Protection in Poland - That is: About the Reform We Need

• Języki publikacji: PL

Abstrakty

Gruntowna zmiana systemu ochrony zdrowia dokonuje się pomimo, że faktycznie system nie jest przez nikogo celowo reformowany. Istnieje jedynie powszechna świadomość konieczności i wręcz nieuchronności zmiany oraz nie mniej powszechne przyzwolenie na zmianę. Brak jest natomiast zgody, co do zakresu ("głębokości"), kierunku, charakteru i sposobu przekształcania systemu. Innymi słowy nie ma powszechnie akceptowanego pomysłu na reformę, może poza zgodą, co do głównego celu reformy, dzięki której za te same środki finansowe mamy uzyskać więcej, wyższej jakości świadczeń/usług medycznych lub jedno i drugie.(fragment tekstu)

EN

The thesis - challenged presumably by no one - that the current condition of health protection in Poland requires an immediate quantitative and quality change has led to the already common belief that necessary and the most appropriate way of carrying this change out is a comprehensive reform of the system of health protection (SOZ). The strategic objectives of the reform are the following: increasing the range of health services and the number of medical services, improvement in the quality of the services, decreasing their cost and improvement in the accessibility to the services. The operational objectives are primarily the following: granting the hitherto SOZ procurement model a fully insurance-oriented character, introducing private and mutual complementary insurance (above the standardized one and supplementary one), introducing parallel or alternative insurance in the face of basic insurance. The effective implementation of the reform depends both on the will and initiative of the 66 present government, and it also takes into consideration various, specific Polish social and cultural constraints as well as formal and legal, technological, demographical and economical ones. The aforementioned entanglements and numerous constraints pose the biggest threat to the change being designed. In the face of so many constraints and ideological and political entanglements, the chance for this reform is in its political neutrality which is possible due to basing it on (1) provisions prakseologically plausible and economically rational, and (2) complete submitting the organizations to the mode of financing and functioning of both SOZ models - the public and private/mutual ones to the concept of insurance, and uniform functional and organizational as well as financial insurance mechanisms. The reform, which is being anticipated by contemporary Polish people, the way it should be like and the way it realistically can be like, must therefore be the result of a multi-dimensional consensus. Is, however, such a consensus possible at all, shouldn't it be perceived only in the categories of a postulate having the character of a theoretical construct that is theoretically conceivable but realistically impossible? That cannot be excluded. In such a situation, perhaps, we are to face a social change with an uncontrolled course and unpredictable results. The boldest scenario of such an uncontrolled change is a fall of all the imponderabilities that are currently commonly recognized and the whole paradigm of social securities, including primarily redefining and changing of the basic provisions on which the paradigm dominant in the contemporary security systems and heath insurance are based. (original abstract)

Słowa kluczowe

PL

Ochrona zdrowia; System ochrony zdrowia; Świadczenia zdrowotne

EN

Health care protection; Health care system; Health care benefits

• Czasopismo: Rozprawy Ubezpieczeniowe
• Rocznik: 2008
• Numer: nr 2(5)
• Strony: 55--67

Twórcy

autor

Romuald Holly

• Uniwersytet Medyczny w Łodzi

Bibliografia

• 1. R. Holly, Dodatkowe ubezpieczenia zdrowotne we współczesnej polskiej polityce zdrowotnej i reformowanym systemie zdrowia (w:) Polityka Zdrowotna, t. VI, X 2006, s. 27
• 2. R. Holly, Racjonalna polityka zdrowotna a procedury i standardy medyczne w systemie ochrony zdrowia (w:) Polityka Zdrowotna, t. I, IX, 2004. s. 10.
• 3. R. Holly, A. Lewiński, Polityka i doktryna zdrowotna oraz reformowanie ochrony zdrowia w Polsce - kierunek dryfu (w:) Polityka Zdrowotna, t. VI, s. 5-7.
• 4. R. Holly (w:) T. Szumlicz (red.), Ubezpieczenia w systemie ochrony zdrowia, Biblioteka Ubezpieczeniowa PIU, Warszawa, lipiec 2008, s. 70-71.
• 5. K. Łanda (red.), Podstawowe cechy i zasady tworzenia koszyków świadczeń zdrowotnych w wybranych krajach, HTA Consulting, Kraków 2006.