TYPE OF HEALTH CARE SYSTEM & PHILOSOPHY /PRINCIPLES
In the Czech Republic, the health care of the population is an important part of state policy and its provision is guaranteed by the Constitution of the Czech Republic. It includes the Charter of Fundamental Rights and Freedoms, which states: “Everyone has the right to health protection.” This constitutional right for its inhabitants is fulfilled by the Czech Republic through a public health system, which operates under Act 48/1997 Coll. (Public Health Insurance Act).
The health care system in the Czech Republic is not unique in Europe and is generally ranked among the models of the European insurance system based on the principle of solidarity. This means that all inhabitants of the Czech Republic are obliged to contribute, according to the rules established by the state, to insurance funds, from which the health care is subsequently reimbursed according to the needs of the patients.
The subjects of the health system
The Czech health system is built on three entities, which are:
- health insurance payers
- health insurance companies
- healthcare providers
The obligation to pay health insurance in the Czech Republic is for:
- All citizens who have permanent residence in the Czech Republic and their children, including foreigners with permanent residence in the territory of the Czech Republic (foreigners who have a permanent residence permit).
- Employees of the employer with headquarters in the Czech Republic, including foreigners without permanent residence in the Czech Republic.
- Children born to foreigners with permanent residence, including children born to foreigners who have already applied for permanent residence.
- Children – foreigners assigned to substitute education.
- Asylum-seekers – are entitled to permanent residence in the territory of the Czech Republic for the duration of the asylum decision. Children born to asylum seekers are considered as foreigners with a permanent residence permit for the purposes of public health insurance until the asylum or other type of residence of the child is decided.
- Aliens with a visa for temporary protection or for the purpose of tolerance of residence.
Ways of payment and amount of premiums
The premium is set at 13.5%. For employees, the employer pays 9% and the employee contributes 4.5% of the gross wage. Self-employed persons pay a full 13.5% of their gross profits each year for the past year, with a minimum amount – the so-called minimum assessment base – set by the state. For 2017, the minimum deposit amount is CZK 1 906. This amount changes with respect to the increase in the average wage in the Czech Republic every year and therefore the level of minimum reimbursement for the self-employed is currently being monitored. The third possible payer of health insurance in the Czech Republic is the state. It shall take over the payment obligation in the following cases:
- Children and students under the age of 26
- Women on maternity leave
- People in social need
- Asylum seekers
The amount of premiums paid by the state to these persons without taxable income is 13.5% of the minimum wage for the previous year. The minimum wage in the Czech Republic in 2016 was 9 900 CZK, so the state health insurance in 2017 was 1 337 CZK. Health insurance payments are paid to health insurance funds. In the Czech Republic we currently have 9 health insurance companies:
- General Health Insurance Company VZP
- Health Insurance Company of the Ministry of the Interior of the Czech Republic ZPMVČR
- Employee Insurance Company Škoda ZPŠ
- Military Health Insurance Company VoZP
- The Brethren Cash Treasury-RBPZP Health Insurance Company
- Occupational health insurance company for employees of banks, insurance companies and construction industry OZP
- Czech Industrial Health Insurance Company ČPZP
Methods of reimbursement of health care in the Czech Republic:
Healthcare providers (both outpatient and inpatient care facilities) are paid from insurance funds. The insurance providers conclude a contract on the manner and amount of reimbursement for the services provided so as to ensure sufficient quality care.
Range of health care provided
Every insured person in the Czech Republic has the right to free health care. The range of this care includes:
- Outpatient and institutional care
- Emergency medical care with payment of the regulatory fee from the patient 90 CZK
(The time coverage of emergency care is on Saturday/ Sunday or on a holiday for
24 hours and on working days between 17:00 and 07:00.)
- Long-term professional care
- Preventive care
- Medicines (for each drug group, one is provided free of charge, the others are with the patient’s financial contribution)
- Dental care – only basic material, usually the patient is paying for more care
- Spa treatment
- Transportation of patients by emergency services
- Checking the deceased
Health care that is not covered by health insurance must be covered by the patient himself:
- Above standard medical and nursing activities
- Some performances that are not of a purely therapeutic nature (various medical testimonials, certificates, statements, etc.)
1/ Listina základních práv a svobod. Available from: https://www.psp.cz/docs/laws/listina.html (2018-02-14)
2/ Systém a organizace zdravotní péče. Available from: https://www.domavcr.cz/rady-pro-zivot-v-ceske-republice/zdravi-a-lekarska-pece/system-poskytovani-zdravotni-pece-v-cr (2018-02-14)
3/ Zdravotnictví a zdravotní pojištění. Praha: Česká lékařská společnost J.E. Purkyně, 1997.
4/ ŠULCOVÁ, Margaréta. Veřejné zdravotnictví: učební texty pro zdravotnické obory. Ústí nad Labem: Univerzita Jana Evangelisty Purkyně v Ústí nad Labem, Fakulta zdravotnických studií, 2017.