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"Poles Agree on Health Reform: Regional health insurance funds to be financed with payroll taxes" - This reprint from Okno Group's Environment & Health is copyright ©1998 by Okno Group; all rights reserved. The first few paragraphs of the article follow; the complete article is available in a PDF file through the link at the end of the text. |
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From Environment & Health
Volume 3, Number 3 (September 1998)
Regional health insurance funds to be financed with payroll taxes
Poles Agree on Health Reform
By Steven J. Norton
After months of argument, the Polish parliament passed the government’s version of health insurance reform on 18 July. The bill sets up regional health insurance funds next year in each of the newly redrawn regions (voivodships) created under a sweeping administrative reform; the health funds would be financed by a portion of the payroll tax, set at 7.5% of gross wages. The bill, a package of amendments to the health insurance law passed last year, caused controversy both because it decentralized health insurance and because it did not dramatically raise health funding. The act passed on a party line vote, with both parties in the governing coalition -- Solidarity Electoral Action (AWS) and Freedom Union (UW) -- backing the measure.
Voting for the act took considerable courage for the AWS, which had campaigned in last year’s elections for greater spending on and wider access to health care. AWS ministers and party leaders had pressed for a much higher tax contribution rate -- as much as 11% -- to help fund the beleaguered sector. The more fiscally-conservative UW, led by Finance Minister Leszek Balcerowicz, argued that devoting more of the fixed total of payroll tax to health care meant ballooning the broader government budget deficit and threatening the country’s economic growth. The compromise figure that emerged from negotiations within the government represents only a modest increase over current funding levels. Organizations representing doctors, nurses, and other health-care workers, along with center-left opposition parties, object to the minimal increase. [See E&H Mar/Apr 98.] The coalition parties had to fend off several alternative bills, some sponsored by AWS deputies, which would have mandated various higher contribution rates for health insurance....
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