The amendment to the Act on the Medical and Dental Professions and certain other acts introduces significant changes to the financing system of the Polish public healthcare system. According to the new regulations, the National Health Fund (NHF, Polish: Narodowy Fundusz Zdrowia, NFZ) was tasked with financing a wide range of non-insurance-based services, which were previously financed from the state budget and guaranteed to all people in Poland, regardless of their statutory insurance status.
The NHF took over the financing of
- emergency medical services;
- medicines for people over 75 and pregnant women;
- highly specialized services;
- compulsory vaccinations;
- insurance contributions for students, soldiers and the unemployed; and
- medicines under the health policy programmes of the Ministry of Health:
- treatment of haemophilia,
- antiretroviral treatment for people living with HIV, and
- antiviral treatment for hepatitis C for prisoners.
Previously, all these tasks were financed from the state budget. Currently, these tasks are financed from compulsory health insurance contributions (paid as a payroll tax via the social insurance system), without any further increase in this source of NHF income [2].
The reform was met with numerous protests from the medical community, mainly due to the lack of guaranteed additional financial resources for the NHF. As a result, patients’ access to health services may be restricted. The reform was introduced at a time when the NHF has been experiencing a budget surplus since 2021 due to unused health services, initially due to COVID-19 and later due to a shortage of professionals [3]. The surplus is also the result of a new tax reform that increased the health care contributions of self-employed people with higher incomes [4].