As Radio Prague notes, the debt of foreign patients to Czech medical facilities is a long-standing problem that the Ministry of Health hopes to at least partially solve. How? By adopting a new law on health insurance for foreigners.
However, the optimism of the Ministry of Health is not shared by all parties interested in resolving the protracted issue. The new law should affect foreigners who live and work in the Czech Republic for a long time and pay for commercial health insurance. The norm assumes that commercial insurance in terms of its coverage of healthcare services should approach the volume of medical services in the public health insurance system, which is used by Czech citizens and persons who have obtained permanent residence in the country.
This was confirmed to Czech Radio by Deputy Minister of Health Helena Regnerova: "This law should clearly define which types of services cannot be excluded from the health insurance policy. That is, we are talking about those exceptions to the rules that were previously set by the insurance companies themselves. In most cases, companies introduced rules that were financially disadvantageous for them. According to the new law, the rules would be tightened, but at the same time the insurance would cover a wider range of services provided, so such debt from foreign non-payers would not arise."
Such a law is toothless, as it cannot solve the main problem, believes Ladislav Švec, director of the Office of Compulsory Health Insurance. The draft law, which commercial insurance companies are currently not commenting on, should be considered by the end of this year.
"Overdue debts for the provision of medical services and hospital treatment that fall into the category of unrecoverable will always arise in our republic. This circumstance, like the new law, directly concerns not only people who have comprehensive commercial medical insurance – these are mostly entrepreneurs and their family members from non-EU countries. It also concerns people who are here illegally, temporarily, who have not obtained the right to long-term stay in the Czech Republic, who either have a policy covering emergency medical care or have no insurance at all," explained Švec.
The problem also lies in the fact that many foreigners living in the Czech Republic, who spend a total of about 20,000 crowns (780 euros) per year on commercial health insurance, use medical services to a very limited extent because they fear an increase in additional costs. In many cases, they are not even aware of what kind of complications or diagnoses their policy entitles them to.
"In many cases, foreigners do not use medical care in a timely manner, even though they are entitled to it, which exacerbates their problems. They are afraid that their commercial insurance will not cover the necessary treatment costs. Thirty percent of medical services used by foreign patients in the category of those with commercial insurance are paid for by their policy. In addition, another 60% they pay out of their own pocket. Ten percent they no longer pay, thus remaining in debt to medical facilities and hospitals," says Lukáš Vimr, head of the non-profit organization Center for the Integration of Foreigners.
Foreigners owe primarily to hospitals, which later have to recover the debt from non-payers, and also, in an effort to avoid such a situation, require foreigners to pay a deposit for services in advance. Previously, Czech hospitals postponed the resolution of the financial issue to the future.
"We encounter cases where foreign parents have paid insurance, but their child does not, and the costs can reach millions. Moreover, in the Czech Republic, it has still not been decided who should ultimately pay off such debts. Therefore, today, when admitting patients to the hospital, we already try to anticipate the amount for specific services and demand from foreigners, if they have a bank card or cash, to pay as high a deposit as possible," said Miloslav Ludvík, a member of the committee of the Association of Hospitals and director of the Prague Motol Hospital.
Despite these measures, foreigners already owe Motol 40 million crowns. However, as employees of the largest medical center in the republic explain, the debts here have accumulated over a longer period. Last year, it was reported that since 2000, Motol has been trying to recover debts from foreign clients in the amount of 37 million crowns. Lukáš Vimr believes that the situation could be helped by allowing foreigners to use the public health insurance system.
"The inflow of funds into the Czech public health insurance system would be much more powerful, and the accessibility of care for foreigners in the category of those paying for a medical policy would improve," concludes Lukáš Vimr.