• Spending overview
• Policy overview
• Diseases overview

Spending overview

Poland spent an estimated 6.7% of GDP on healthcare in 2009, which is low for an OECD member, and lower than in Hungary, the Czech Republic or Slovakia. Despite this relatively low level of spending, Poland's healthcare indicators have improved significantly since 1990, a trend that is expected to continue during the forecast period.

The health system's financial problems have eased since 2005 as rapid economic growth and rising employment have boosted the National Health Fund’s (NFZ) income from the earmarked income tax. Despite this, some hospitals are still heavily indebted and the health system's financial situation remains vulnerable, particularly in the context of the current economic slowdown.  The government accounted for around 71% of total health spending in 2007, according to data from the OECD. Public-sector healthcare is funded through an earmarked income tax, with the national health fund purchasing services from hospitals and doctors. Healthcare is theoretically free at the point of use in Poland, but under-the-counter payments to doctors and other healthcare workers are common to help obtain speedier or better care.

In June 2009 the Ministry of Health submitted a proposal that additional health insurance be levied from 2010 in order to supplement the earmarked budget income, although it is uncertain that this measure will suffice. The current government has indicated that there could be a further rise in the earmarked health tax, to 10% of earnings in 2010.

Policy overview

The current government has put forward several proposals to improve the functioning of the health system, including shifting public hospitals from their current non-commercial status. This step is intended to improve financial control in public hospitals, but has been described as privatisation by the main opposition party. In order to spur private-sector participation in the healthcare system, in March 2009 the government announced that Zl 1.15bn (US$350m) in budget funds would be set aside over a two-year period for local authorities to turn hospitals under their control into commercial entities.

The government wishes to encourage more of the population to take out additional private insurance to fund services not financed by the NFZ. However, these plans are also likely to run into political resistance, and with work progressing only slowly on specifying the basket of services to be provided by the NFZ, they too may not be implemented before the presidential election in late 2010.

The Polish healthcare system is currently ranked 26th out of 33 in Europe. The report singled out the financing of the healthcare system as a particular weakness. Unless individual co-funding is introduced, which appears politically very unlikely, the functioning of the public healthcare system is not expected to improve significantly over the forecast period. Popular dissatisfaction with the operation of the public health system will remain high, and the long-established problems of long waiting times and widespread corruption are likely to continue.  This may encourage the further development of the market for private health insurance services, both for individuals and for company-provided schemes for employees. The market is already growing quickly, and around 900,000 people were covered by private medical insurance in 2007.

Diseases overview

After falling in the early 1990s, life expectancy has improved steadily. Average life expectancy at birth was an estimated 76 years in 2009.  This compares poorly with western Europe (with an average life expectancy of around 80 years), but is similar to the Czech Republic and Slovakia, and well ahead of Hungary and Russia. The main causes of death are circulatory diseases (responsible for 46% of deaths in 2005) and cancers (responsible for 25% of deaths in 2005).

The WHO estimates that around 20,000 people in Poland were living with HIV in 2007, with up to 200 a year dying of AIDS. Compared with similarly sized countries in western Europe, this is a relatively low rate of infection, but it has risen rapidly since the epidemic started in 1985. The WHO reports that Poland has made considerable progress in introducing education and treatment programmes to combat the disease. However, a report published in September 2009 by Health Consumer Powerhouse ranked Poland's level of care and support for HIV sufferers as "mediocre" relative to its EU peers. The report singled out monitoring and data availability as areas where improvement is necessary.