Public health outcomes and the neoliberal health system in Poland

The paper discusses the relationship between the dysfunction of the market health system implemented since the beginning of the twenty-first century in Poland and the scale of the country’s health crisis. Life expectancy and mortality of population in Poland deteriorated more during the COVID-19 pandemic than in most European Union countries. We argue that rather than being attributable solely to the pandemic, the health crisis is a consequence of nearly two decades of public health marginalisation, shortcomings in health promotion, disease prevention and healthcare, especially alcohol-related and infections-related diseases. We show that while in the first decade of the political transformation (1990–2000), the increase in average life expectancy in Poland was one of the fastest in Europe, it stalled and subsequently froze against a series of neoliberal reforms since 2002. We present a historical analysis of the neoliberal turn in the Polish health system, arguing that it has led to a vicious cycle, whereby low public investment in public health, driven by the forces of neoliberal market mechanisms, contribute to higher morbidity and mortality from preventable diseases, increasing the population’s need for restorative treatments and widening health inequalities in society, which in turn put an upward pressure on the cost of treatment and medical staff workloads, thus raising the budgetary requirements in the health sector that divert away resources from long-term care, prevention and public health initiatives.