Medical Savings Accounts and Healthcare Reform in Poland: A Critical Analysis

The healthcare system in Poland is controversial. Waiting times for tests, procedures, surgeries, or appointments with specialists are often last many months. From this perspective, the healthcare system in Poland is inefficient and underfunded . There is a widespread belief in Polish society that, thanks to the Christmas Charity Orchestra, among other initiatives, hospitals receive some funding. In reality, this translates into funding from individual household budgets. From an economic perspective, significant elements of the healthcare cost structure include: personnel costs for employees, primarily doctors and nurses; ongoing maintenance costs of healthcare infrastructure, including repairs to fixed assets; energy costs; pharmaceutical costs; investments; and so on. Healthcare spending is steadily rising, not least because of Poland’s aging population.

The Polish healthcare system has evolved from a model reminiscent of Siemiaszko’s centrally planned model to a blend of Bismarck’s model based on social insurance, Beveridge’s national healthcare system, and elements of a free-market model, where patient care has become a marketable commodity, with patients bearing the costs personally or through health insurance. Some countries have adopted financing for the healthcare system through so-called individual health accounts or medical savings accounts. This model is in effect in Singapore, China, South Africa, and, to some extent, the United States. In Poland, a similar solution was proposed in 1992 by a team of people represented by Zygmunt Hortmanowicz, himself a physician. The proposed solution was not adopted, and the idea of establishing a Health Protection Bank (BOZ) was also rejected. Many experts believe that a system involving individual health accounts cannot fully finance the growing needs of healthcare, especially with regard to the financing of chronic disease treatment and expensive surgical procedures.