Can people afford to pay for health care? New evidence on financial protection in Czechia

Overview

This review is part of a series of country-based studies generating new evidence on affordable access to health care (‎financial protection)‎ in health systems in Europe. Financial protection is central to universal health coverage and a core dimension of health system performance. Catastrophic health spending is lower in Czechia than in many European Union countries. It is heavily concentrated in the poorest quintile and older people and mainly driven by outpatient medicines. Levels of unmet need are below the European Union average but there is notable income inequality in unmet need for dental care. Financial protection is undermined by persistent gaps in health care coverage: mechanisms to protect people from co-payments are not designed to protect people with low incomes; corrective lenses are not well covered for adults; although dental care is covered, many dentists avoid offering covered services or using covered materials; and waiting times and informal payments are an issue for outpatient visits. Efforts to improve financial protection should focus on minimizing “avoidable co-payments” for outpatient prescribed medicines; expanding coverage of dental care, including the use of higher-quality materials and improved access in underserved areas; expanding coverage of medical products for people with low incomes; addressing long waiting times and informal payments and enforcing laws prohibiting extra billing; and finding ways to ensure the whole population is covered. To meet equity and efficiency goals now and in the future, the Government should ensure that public spending on health is carefully targeted to reduce financial hardship and unmet need for households with low incomes and that the social health insurance scheme’s revenue base is broad enough to generate sufficient funding as the population ages.