SGH experts presented 10 ways to fill the financial gap in the National Health Fund

Raising the health insurance contribution to 10%, introducing a "fat tax" and a fee of PLN 10 for a visit to a clinic - these are some of the solutions from the SGH report "10 new sources of financing for the National Health Fund", which will help fill the gap in health financing.

Other solutions presented on Monday in the report by SGH experts include: paying health insurance contributions by employers, financing children's health insurance contributions from the state budget, equalizing the retirement age of women and men, transferring part of the excise tax for health purposes, limiting preferential insurance in the Agricultural Social Insurance Fund (KRUS), financing emergency care and medical rescue from the state budget, supplementary health insurance and the possibility of transferring 1.5 percent of tax for health care.

The authors of the report estimated that in the years 2025-2027 the gap in the NHF finances will amount to a total of approx. PLN 111.4 billion. In the report, they assumed that this is the difference between the revenues from health insurance contributions and taxes for the NHF purposes, and the statutory ceiling for financing health care expenditure in relation to GDP.

Dr. hab. Monika Raulinajtys-Grzybek, prof. of SGH, noted at the conference in Warsaw that the 10 proposals from the report are a "menu placed on the table" that allows for the development of various strategies in connection with the financial gap.

"We treat the report as an invitation to talk," she said.

She noted that healthcare is becoming increasingly dependent on budget financing, and the report allows for discussions about who should pay for healthcare and what this system should look like.

Experts stressed that the changes are necessary because the healthcare system will be increasingly burdened due to demographic changes and an ageing society.

"We propose to equalize the contribution burden for risk groups," said Dr. Barbara Więckowska, professor at SGH.

Experts noted that introducing necessary and logical changes will be a challenge.

Dr. Hab. Anna Ruzik-Sierdzińska, prof. SGH, pointed out that political economy shows that it is unrealistic to raise women's retirement age by five years in five years, as proposed by the authors of the report. She also noted that many women remain on the labor market after the age of 60.

Political marketing expert from SGH, Dr. Mirosław Oczkoś, emphasized that the obstacles to introducing changes are "information noise", fragmented perception of the system and improper information to the society about why changes are needed. He noted that there are no politicians who would "pounce" on the demand to raise the health insurance contribution.

The authors of "10 new sources of financing for the National Health Fund" proposed increasing the health insurance contribution for employees, retirees and pensioners by 0.25 percentage points per year for 4 years to 10% of the contribution and increasing the contribution for the self-employed nominally corresponding to the increase in the contribution for employees. At this point, they proposed limiting the entitlement to preferential insurance in KRUS to people who support themselves from work on a farm, which would bring a total of PLN 36.6 billion in 2025-2027.

Another solution is to introduce a 2.5% health insurance contribution paid by employers – a total of PLN 41.9 billion over three years. In turn, financing health insurance contributions for children from the state budget in the amount of 4.5% of the minimum gross salary means an inflow to the National Health Fund of PLN 16 billion per year, or PLN 48 billion in the analyzed period – according to the report.

According to the authors of the report, equalizing the retirement age for women and men could ultimately increase the revenues of the National Health Fund by PLN 5.7 billion in 2025-2027.

They noted that taxes on "health sins" in 2024 constituted PLN 1.9 billion in the National Health Fund budget, and their potential increase could increase revenues by a total of PLN 2.1-3.0 billion in 2025-2027. The authors of the report mention the "sugar tax" and the new "fat tax" in this point. They also propose transferring part of the excise tax to health purposes, which could bring PLN 12.5 billion over three years.

Financing emergency care and medical rescue from the state budget is an expected revenue of PLN 13.8 billion – it was noted.

Another solution is co-payment for selected health services, which could bring an additional PLN 2.1 billion per year (PLN 6.3 billion in total in 2025-2027). This would involve small fees, e.g. PLN 10 for an outpatient visit and PLN 50 for a hospital stay – the report assumes rates at a level corresponding to values ​​in other European countries using this solution.

The proposals also include supplementary private health insurance in the amount of PLN 50 per month. Assuming that the population of insured persons would amount to 10%, additional revenues from insurance could amount to PLN 2.1 billion per year, or PLN 6.3 billion in the period 2025-2027 - it was estimated.

The authors of the report noted that the possibility of transferring 1.5% of tax to healthcare would amount to PLN 0.02 billion, or PLN 0.06 billion over a three-year period. They emphasized that over 86% of all NFZ revenues are revenues from health insurance contributions. The entity-based subsidy for the NFZ is a supplement to the sources of financing services. (PAP)

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