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One or More Payers for Healthcare Financing: The Experience From Poland and Czechia

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Listed:
  • Pawel Bialynicki‐Birula
  • Lucie Burianová
  • Jacek Klich
  • Jan Mertl
  • Adam Šimčík

Abstract

This paper focuses on circumstances and consequences of health payers' configuration in Poland and Czechia since the 1990s. It aims to identify the differences in healthcare financing between the two neighboring countries that had started from a similar position, but eventually incorporated different arrangements of payers. The paper conducts comparative analysis of four distinctive elements: the configuration of contracting and payment methods, the power of the payers, coverage and contributions, and the dominant anchor's search attempts. The results map the evolution of healthcare in both countries with a focus on the payers' role, show the payers' economic position and behavior to providers, citizens and health policy authorities. Polish single‐payer system was identified as cheaper and more effective for administratively based expenditure control, while the Czech multipayer one showed higher institutional stability and a wider coverage paid by public health insurance. The paper brings an empirical assessment of existing theoretical knowledge concerning the options for a payers' configuration, demonstrating that the choice and adjustments thereof are country‐specific and depend on the preferred priorities of health policy.

Suggested Citation

  • Pawel Bialynicki‐Birula & Lucie Burianová & Jacek Klich & Jan Mertl & Adam Šimčík, 2025. "One or More Payers for Healthcare Financing: The Experience From Poland and Czechia," Economics and Politics, Wiley Blackwell, vol. 37(2), pages 616-637, July.
    • Handle: RePEc:bla:ecopol:v:37:y:2025:i:2:p:616-637
    DOI: 10.1111/ecpo.12330
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    References listed on IDEAS

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    1. Cuadrado, Cristóbal & Crispi, Francisca & Libuy, Matías & Marchildon, Gregory & Cid, Camilo, 2019. "National Health Insurance: A conceptual framework from conflicting typologies," Health Policy, Elsevier, vol. 123(7), pages 621-629.
    2. Hsiao, William C. & Cheng, Shou-Hsia & Yip, Winnie, 2019. "What can be achieved with a single-payer NHI system: The case of Taiwan," Social Science & Medicine, Elsevier, vol. 233(C), pages 265-271.
    3. Polak, Paulina & Świątkiewicz-Mośny, Maria & Wagner, Aleksandra, 2019. "Much Ado about nothing? The responsiveness of the healthcare system in Poland through patients’ eyes," Health Policy, Elsevier, vol. 123(12), pages 1259-1266.
    4. Christopher Cai & Jackson Runte & Isabel Ostrer & Kacey Berry & Ninez Ponce & Michael Rodriguez & Stefano Bertozzi & Justin S White & James G Kahn, 2020. "Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses," PLOS Medicine, Public Library of Science, vol. 17(1), pages 1-18, January.
    5. Remers, Toine E.P. & Wackers, Erik M.E. & van Dulmen, Simone A. & Jeurissen, Patrick P.T., 2022. "Towards population-based payment models in a multiple-payer system: the case of the Netherlands," Health Policy, Elsevier, vol. 126(11), pages 1151-1156.
    6. Hussey, P. & Anderson, G. F., 2003. "A comparison of single- and multi-payer health insurance systems and options for reform," Health Policy, Elsevier, vol. 66(3), pages 215-228, December.
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