CZECH REPUBLIC

The Czech health-care system is based on compulsory statutory health insurance providing virtually universal coverage and a broad range of benefits, and doing so at 7.7% of GDP in 2012 – well below the EU average – of which a comparatively high 85% was publicly funded. Some important health indicators are better than the EU averages (such as mortality due to respiratory disease) or even among the
best in the world (in terms of infant mortality, for example). On the other hand, mortality rates for diseases of the circulatory system and malignant neoplasms are well above the EU average, as are a range of health-care utilization rates, such as outpatient contacts and average length of stay in acute care hospitals. In short, there is substantial potential in the Czech Republic for efficiency gains and to improve health outcomes. Furthermore, the need for reform in order to financially sustain the system became evident again after the global financial crisis, but there is as yet no consensus about how to achieve this.

The Czech Republic has a system of statutory health insurance (SHI) based on compulsory membership of a health insurance fund, of which there were seven in 2014. The funds are quasi-public, self-governing bodies that act as payers and purchasers of care. The core health legislation of the Czech Republic was adopted in the 1990s and has changed only marginally since then.
The Ministry of Health’s chief responsibilities include setting the health-care policy agenda, supervising the health system and preparing health legislation. The Ministry also administers certain health-care institutions and bodies, such as the State Institute for Drug Control (SÚKL), which is the main regulatory body for pharmaceuticals.
The 14 regional authorities (kraje) and the health insurance funds play an important role in ensuring the accessibility of health care, the former by registering health-care providers, the latter by contracting them. Czech residents may freely choose their health insurance fund and health-care providers. The health insurance funds must accept all applicants; risk selection is not permitted (though there is risk equalization between the funds, see below).
The use of information and communications technology (ICT) is generally underdeveloped in the Czech Republic; for instance plans to implement national e-health capacities have not been realized. Similarly, efforts to develop approaches for health technology assessment have not yet materialized into an infrastructure for using HTA in practice.