Controversial Sanctions in the Payment Ordinance Stir Up Practitioners

The proposal of the payment ordinance for the upcoming year has provoked strong reactions among practitioners, as it aims to oblige hospital doctors and general practitioners to serve on emergency duty. According to the Ministry of Health, failure to fulfill this obligation would reduce the funds received from insurance companies for patient care. However, practitioners vehemently disagree with this approach.

Practical Doctors’ Association chairman Petr Šonka stated, “We had a meeting with the Ministry of Health, and we were assured that it wouldn’t be included in the ordinance. This is unacceptable for general practitioners.”

He expressed dissatisfaction, saying, “The emergency service contract goes beyond the contract I have with the health insurance company as a general practitioner. It’s wrong to tell me that if I don’t take on another contract, especially under conditions I can’t influence, they won’t pay me for my work in the system.” He also pointed out that while general practitioners are expected to serve on emergency duty, no such sanctions apply to outpatient specialists.

Michal Čarvaš, chairman of the Association of Czech and Moravian Hospitals, criticized the Minister’s promise, stating, “The Minister promised that it would be included and would compel general practitioners to participate in emergency services in some way. If this is not the case, I consider it a broken promise.”

The Ministry has proposed that if a region requests a doctor to provide emergency services and the doctor fails to fulfill this obligation, a penalty will be imposed on the payment received from the insurance company for each patient. On the other hand, if the services are covered, a bonus will be granted.

The Union of Employers’ Associations and the Czech Stomatological Chamber also raised objections. The latter criticized the model in which the Ministry allocated additional funds for registering new patients and preventive check-ups but reduced the budget for treatment. Stomatologists argued that “registration alone does not help the patient.” They also expressed discontent with the reduced funding for orthodontics.

However, the most contentious aspect of the ordinance revolves around remuneration. The Czech Medical Chamber has presented the most comments thus far, and labor unions have also voiced their concerns.

The Confederation of Trade Unions agrees with the proposal to increase reimbursements by six percent, provided that additional adjustments are made to increase remuneration for healthcare and non-healthcare workers. They are also seeking salary increases directly in the tariff system. Minister Vlastimil Válek (TOP 09) announced on Sunday that certain salary groups would revise the remuneration system.

Next year, hospitals providing acute care are expected to receive an average six percent increase from health insurance companies. Hospitals offering subsequent care will receive an eight percent increase. However, the Czech Medical Chamber has persistently insisted on a 15 percent increase, even though health insurance companies in the Association of Health Insurance Companies proposed a maximum of one-third, and the General Health Insurance Company presented a maximum of eight percent.

The public health insurance system’s revenues are projected to be 499.5 billion Czech koruna next year, with expenditures totaling 508 billion.