In a recent interview, Czech Minister of Health Vlastimil Válek (TOP 09) introduced a novel idea to enhance accessibility to non-urgent medical care for residents living near the Czech border. His proposal suggests that individuals should have the option to seek medical treatment in neighboring countries if it is more conveniently located, with the costs covered by their regular health insurance. This concept aims to address the challenges faced by residents living in border regions, who often encounter significant travel times to access healthcare in their home country.

Válek’s proposition underscores his commitment to improving healthcare accessibility for those who live in areas where the closest medical facilities are located across the border. It is particularly advantageous for residents in towns such as České Velenice, near the Austrian border, who could reach the nearby Gmünd hospital in just five minutes, as opposed to traveling for an hour to reach Czech hospitals in České Budějovice. Similarly, residents of Javorník in Horňácko, when in need of medical attention, must often make lengthy commutes to hospitals in Uherské Hradiště or Kyjov, which can take up to three-quarters of an hour, whereas reaching the Slovakian Myjava by car only takes 15 minutes.

However, while the idea of seeking medical care abroad is not entirely new, the current challenge lies in the reimbursement process. Czech patients who undergo treatments in foreign countries often encounter difficulties when seeking reimbursement if their health insurance provider does not pre-approve the procedure. In such cases, patients must cover the costs upfront and then apply for reimbursement, which is not guaranteed. One of the requisites for reimbursement is a medical recommendation for the treatment. It should be noted that emergency care received abroad is automatically covered by insurance, with patients only responsible for co-payments and local fees.

Válek’s vision involves reinstating a functional model reminiscent of the time when the Czech Republic and Slovakia were part of a single nation, allowing residents in border regions to seek medical treatment on either side. However, it’s worth noting that the confidence Czech citizens have in the healthcare systems of Germany or Austria may not extend to Slovakia, posing a potential challenge.

The potential inclusion of this system is envisioned in a comprehensive amendment to the public health insurance law. However, the details of this proposal are yet to be disclosed to the insurance companies directly affected by it.

Martin Balada, the CEO of the Association of Health Insurance Companies, recognizes the potential for increased accessibility to planned medical care, but he also emphasizes the possible negative consequences. Balada points out that directing a significant portion of the Czech public health insurance system’s financial resources to foreign healthcare providers without effective negotiations between payers and providers could impact the funding available for healthcare in the Czech Republic. Furthermore, establishing agreements between insurance companies and hospitals in neighboring countries regarding payment methods, especially in scope and pricing, could give rise to various complications.

Balancing the need for accessible healthcare with the financial considerations of healthcare systems is a complex challenge. Válek’s proposal opens up a discussion on the potential benefits and drawbacks of cross-border medical care access in the Czech Republic and highlights the need for careful planning and negotiation to ensure that residents can access timely and high-quality healthcare without jeopardizing the stability of the national healthcare system.

Article by Prague Forum