Bronislaw Komorowski has been declared the winner of the presidential election in Poland. The centre-right candidate narrowly beat Jaroslaw Kaczynski, twin brother of former president Lech Kaczynski, who died in the Smolensk plane crash three months ago. The outcome of the vote has consequences for the country's healthcare system and knock-on effects for medical tourism, as Komorowski plans to commercialise hospitals.
Dr Peggy Watson of the University of Cambridge, writing in the British Medical Journal, argues that the result could represent the final nail in the coffin of public health services in Poland, where hundreds of thousands of people cannot afford private medical care. The country's hospitals, described as the last bastion of a publicly funded health service, have been the subject of a 10-year privatisation battle. In 2007, the last time the government tried to launch a commercialisation programme, Kaczynski vetoed the attempt. The policy will give Poland's hospitals full market status and open the door to privatisation. Dr Watson says, "A system is emerging in Poland where better care is being offered to people who are better able to pay. Much has been said about the country's growth, but levels of poverty are high. The hospitals are the last bastion of an even health service. There is a real danger that private companies would bring that to an end."
Even the previous government set contributions to healthcare deliberately low, in the expectation that it would lead people to seek more private care and that private health insurance would develop to fill the gap. Several health insurance companies had started activities in Poland, including PZU, Allianz, Generali, Inter Risk and Axa.
In 2009 the Polish private healthcare market was worth €6.4bn, according to a report by PMR, a research and consulting company, entitled “Private healthcare market in Poland 2010.” Private healthcare includes payments for drugs and medical equipment directly from patients’ pockets, cost of rehabilitation, diagnostic tests and doctor’s appointments covered directly from patients’ pockets, subscriptions offered by medical companies together with occupational healthcare services, and health insurance offered by insurance companies. Despite the economic crisis, the leading private medical companies developed their outpatient and inpatient medical services rapidly in 2009.
In the past, private medical companies competed with public bodies mostly over the delivery of outpatient services. As a result of the increase in interest in private healthcare services and the ensuing intensification of competition, combined with an increase in customer demand, private companies have been forced to focus on the development of their outpatient clinics and to build their own hospitals. Lux Med Group opened 11 clinics in 2009. The two private healthcare companies in Poland with the largest hospital chains are Grupa Nowy Szpital and EMC Instytut Medyczny. Grupa Nowy Szpital runs a chain of 12 hospitals, including Nowy Szpital in Olkusz, Nowy Szpital in Krosno Odrzanskie and Nowy Szpital in Szprotawa. EMC Instytut Medyczny operates eight hospitals in the Dolnoslaskie, Mazowieckie, Opolskie, Slaskie and Zachodniopomorskie regions.
The Polish market has recently seen the emergence of non-public hospitals that focus primarily on the provision of services paid for directly by patients, not covered by medical subscriptions or additional medical insurance policies. These hospitals include not only small establishments, which specialise in one-day surgical procedures but also larger, multipurpose hospitals. One example of such a project is the 150-bed St. Raphael’s Hospital in Krakow opened by Scanmed. The hospital now offers orthopedics, general surgery and cosmetic surgery, with plans to add cardio surgery. Luxembourg based health group Medicover opened the country’s first privately financed hospital in July 2009. Warsaw’s Medicover Hospital contains 180 beds, although the number will eventually rise to 270, and offers gynaecology, obstetrics, pediatrics, internal medicine, angiology and cardiology, in addition to surgery. At the beginning of 2010, Carolina Medical Center, in which Medicover holds a stake, opened a 34-bed clinic in Warsaw, which specialises in the treatment of orthopedic injuries associated primarily with sports. The Lux Med Group plans to open a hospital in Warsaw in mid-2010. It will be a small one specialising in one-day surgical procedures. In the long-term, the company intends to open a multipurpose, 50-bed hospital in Warsaw in 2012 or 2013. Medicover intends to open a Radiotherapy Centre in Warsaw and is planning to launch a chain of several small hospitals, which will provide one-day surgical procedures and diagnostic tests in Poland’s major cities. Swissmed, which already has a hospital in Gdansk, began to build a 44- hospital in Warsaw in the spring of 2010.
The combination of the new government’s policy on healthcare, the expansion of private healthcare, and the opening of a number of new hospitals and clinics not dependent on either government finance or insurance companies, will make Poland an even stronger medical tourism competitor in Europe. Private medical and dental care is now available at prices far lower than in Western Europe. It will also be well placed to take Russia and other Eastern European business, where medical tourists currently go to Asia.