Several remarks on the current problems facing Czech healthcare

1. The current method of organization and financing of healthcare leads to reduction of care for the ill.
2. Up to now the care has been virtually borderless, unsystematic and financially exhausting; systematic changes and certain limits on treatment are necessary.
3. It is possible to limit prescription of inexpensive medicines without fundamental contribution to treatment (venotonics, vasodilatans and other), it is appropriate not to cover by medical insurance companies common cheap drugs for treatment of common illnesses (savings approximated by VZP at around one billion CZK).
4. It is necessary to maintain availability of life-saving or considerably life-extending medicines.
5. Basic requirement: the correct drug to the correct patient Securing: concentration of expensive treatment into centres, in the centres an increase of resources for treatment subjected to transparent and simple control, anonymous data from the centres must be commonly available. Centres to be set up on the basis of qualifications, equipment, number of treated diagnosis, evaluation and communication capability.
6. Patients must be honestly informed about the changes in financing of healthcare, also at www.mzcr.cz
7. The most recent and most expensive treatment cannot be available to all patients – as it is in every country in the world. But treatment must always be lege artis – categorically respected recommendations.
8. Possibilities for raising of resources for healthcare (besides rise of the current health insurance):
   A/ introduction of possibility of commercial health insurance
   B/ prescription fees
   C/ fees for appointments with practitioners and ambulatory specialists (we have the highest medical appointment ratio in the world)
   D/ no coverage of food in hospitals, no coverage for common cheap drugs for non-resident treatment by medical insurance companies
   E/ concentration of expensive and complicated treatment into centres will make care less expensive in effect
   All changes mentioned above must be administered in a way that reflects the needs of the socially disadvantaged patients.
   
9. Repeated debt-discharges of hospitals systematically lead to discrimination of hospitals with sound management and lege artis treatment provision. They are demoralizing and ill incentive measures criticized not only by medical persons and patients.

The current situation in healthcare discourages voters from the ruling coalition. System changes in healthcare must be started as soon as possible after the elections without regard to their outcome.

In Brno, March 12, 2006 Prof. MUDr. Jiří Vorlíček, CSc.
President of the Czech Oncological Society of ČLS JEP