Válek Proposes Cross-Border Medical Care to Improve Accessibility

In a recent interview, Minister of Health Vlastimil Válek (TOP 09) suggested a solution to improve accessibility to non-urgent medical care for residents living near the Czech border. He proposed 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.

The Proposal and Potential Benefits

Válek emphasized his desire to allow residents in border regions who do not have easy access to doctors on the Czech side to have the opportunity to receive care in foreign countries where it is more readily available.

This proposition could significantly benefit individuals from towns like České Velenice, situated directly on the Austrian border, who can reach the nearby Gmünd hospital in just five minutes instead of traveling an hour to the Czech hospitals in České Budějovice.

Similarly, residents of Javorník in Horňácko often need to commute to hospitals in Uherské Hradiště or Kyjov, which takes them up to three-quarters of an hour, whereas reaching the Slovakian Myjava by car only takes 15 minutes.

Challenges and Current Limitations

While the idea of seeking medical care abroad is not entirely new, the current issue lies in the reimbursement process. Czech patients undergoing treatments in foreign countries face difficulties obtaining reimbursement if their health insurance provider does not pre-approve the procedure. In such cases, patients must initially cover the costs themselves and later apply for reimbursement, which is not guaranteed.

One requirement 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 copayments and local fees.

The Proposed System and Future Outlook

Válek aims to reintroduce a functional model reminiscent of the time when the Czech Republic and Slovakia were one nation, allowing residents in border regions to seek medical treatment on either side. However, unlike the high level of trust Czech citizens place in the healthcare systems of Germany or Austria, Slovakian healthcare does not enjoy the same level of confidence. The potential inclusion of this system is envisioned in a comprehensive amendment to the public health insurance law. However, he insurance companies directly affected by this proposal are unaware of its details.

Balancing Accessibility and Financial Considerations

Martin Balada, the Association of Health Insurance Companies CEO, acknowledges the potential for increased accessibility to planned medical care. However, he also highlights the possible negative consequences.

Balada emphasizes that directing a more significant portion of the Czech public health insurance system’s financial resources to foreign healthcare providers without these expenses being subject to negotiation between payers and providers could impact the amount of funding available for healthcare in the Czech Republic.

Additionally, establishing an agreement between insurance companies and hospitals in neighboring countries regarding payment methods, especially in scope and pricing, could present various complications.