An outline of needed reforms for the healthcare system: What has the COVID-19 crisis changed?

Limitations on the efficient management of healthcare and on effective management in health facilities have been a constant problem in Poland for about 20 years. The Covid-19 pandemic has uncovered all of the shortcomings of healthcare in Poland, which had consistently been being brought up in expert works and the public debate. Our report on the healthcare interventions that are essential today – at the peak of the Covid-19 epidemic in Poland – is the fruit of presentations and discussions at the mBank-CASE Seminar held on April 15, 2021. Thus far, reform programs haven’t been comprehensive, and even those based on accurate and comprehensive diagnoses of the situation haven’t had a lot of power to enact change. The CASE Foundation has also undertaken work indicating the main causes of healthcare’s ailments and outlining the threats to Poles’ health. Previously, it had analyzed the ineffectiveness of the system after the 1999 reform. Much attention was paid to the dangerous lack of medical and care staff, factoring in the aging population with growing medical and care needs in developing forecasts. Alongside the currently constant theme of underfinancing the healthcare system, much attention has been paid in recent years to the subjects of weak governance; the lack of the necessary information to diagnose problems; the lack of planning, reporting and evaluation procedures; and insufficient dialog with both the public and healthcare workers, resulting in burdensome strikes by nurses, residents, anesthesiologists, and physical therapists. Attention has been drawn to the managerial incompetence of political leaders in the healthcare system, regardless of their occasionally very high medical qualifications. The Covid-19 pandemic has uncovered all of the shortcomings of healthcare in Poland, which had consistently been being brought up in expert works and the public debate. Our report on the healthcare interventions that are essential today – at the peak of the Covid-19 epidemic in Poland – is the fruit of presentations and discussions at the mBank-CASE Seminar held on April 15, 2021 (video: Kierunki niezbędnych reform w ochronie zdrowia – Bankier.pl) They address all the subjects raised at the mBank-CASE seminar in 2018: 1) the need for increased outlays on healthcare, along with more effective allocation; 2) the need for urgent investment in developing medical staff resources; 3) introducing transparent and socially acceptable rules for individual co-payments and 4) efficient public management (governance) of the healthcare system (see Golinowska et al, 2018). Additionally, it introduces the theme of organizing healthcare in relation to the dilemmas of the decentralization and autonomy of the main management entities and facilities that provide healthcare. It also raises the problem of public health and the consequences of neglecting this constantly underappreciated area of healthcare. Each of these subjects requires an explanatory introduction of the categories applied and of more general relevant principles (and theories) which will make it easier to understand our recommendations.