The State System
The state healthcare system is funded in two ways - through government budgets to healthcare and through compulsory individual contributions to the state healthcare insurance scheme.
It is not possible to opt out of the scheme, despite being a low-income earner or part of a vulnerable group; their contributions are deducted from their benefits, however, the amount of each person’s contribution does vary according to income and status.
Employers must register their employees with the health insurance fund when a new employee starts work. Employees pay around 8.5 percent of gross salary to the NHF and this is deducted directly from each person’s salary. Dependant family members are covered by the contributions paid by employed family members. If you are self-employed, your contribution rate will be determined by the amount you earn, but you will have to get additional insurance to cover members of your family.
Foreigners immigrating to Poland without jobs must produce proof of private health insurance in order to obtain their residence permit.
All other groups must register themselves with their local branch of the NHF.
The state fund covers most medical services including treatment by GPs and specialists, diagnostic examinations, hospitalisation, emergency care, prescription medicine and surgical appliances, pregnancy and childbirth and rehabilitation.
Some prescription medicine is subsidised. People still make under-the-table payments to doctors and specialists in the Polish state system in order to assure faster medical treatment.
Those citizens admitted to care or nursing homes for the chronically ill must pay for the costs of their food and accommodation. The same applies to citizens who are referred to rehabilitation facilities.
Doctors and Health Centres
Poland has a lower number of doctors and nurses than most western European countries. The majority of doctors are located in cities and large towns. Doctors are the first point of contact with the Polish health system. Citizens can register with the doctor of their choice and can choose the medical establishment they wish to be treated in, even though they need a referral from their GP to go there. All doctors are required to treat patients in their homes in cases of medical emergency, if an ambulance is not available. The home treatment service has also been extended to include treating many people who would normally go to hospital. The system has worked extremely well in the treatment of chronically ill patients and children.
GPs prescribe drugs, treat acute and chronic illnesses, and provide preventive care and health education.
Health centres provide outpatient care but they do offer a wide variety of specialist services. Medical services provided by health centres include, general practice, maternity care, child healthcare and dental care. They also provide emergency medical aid as well as laboratory, radiology, and other diagnostic services.
Health centres are staffed by qualified doctors and nurses.
There are long waits to see doctors. Waiting times to see doctors vary and it is recommended that you make an appointment in advance. If you need urgent help, you may go to the doctors surgery on speculation, but be prepared for a long wait.
Consultants are senior doctors who have completed a higher level of specialised training. Many consultants who deal with outpatients are private, but in urban areas, they work from health centres and provide treatment a part of the state funded system. GPs refer patients to a consultant if he believes that a patient may need specialist help and diagnosis. There are numerous specialist fields of medicine in Poland like gynaecology, oncology, paediatrics and dermatology. There is often a long waiting list to see consultant doctors, despite the fact that Poland has more consultants than GPs.
Hospitals and clinics exist in all major towns and cities of Poland. Patients are admitted to hospital either through the emergency department or through a referral by their doctor. Once a patient is admitted treatment is controlled by one of the hospital doctors. There are usually waiting lists for non-emergency treatments and services. The state hospital system divides hospitals into different groups according to referral levels. First level referral hospitals are divided into four areas, obstetrics and gynaecology, internal medicine, surgery and paediatrics. Second level referral hospitals are more specialised and provide care in the realms of urology, neurology, cardiology, dermatology and oncology. Third level referral hospitals provide highly focused treatment by leading medical specialists.
Emergency care is available free for everyone including those without state health insurance. However, it is not on a par with Western Europe and time delays between calling the emergency services and receiving treatment are significantly longer. Emergency treatment is provided at the emergency room of some large hospitals in cities, if you are not close to a city, your GP is compelled by law to treat you at home.
Health Resort Treatment
The Polish National Health Service includes free treatment and rehabilitation at many of the country’s leading spa resorts. You have to be referred by your GP in order to benefit from treatment here. The majority of people who are referred receive rehabilitation derived from natural therapeutic sources, like thermal water.
There are many private practices in Poland provided by independent office-based doctors and specialists. The premises, equipment and personnel are funded by the doctors themselves and through private insurance contributions. Private healthcare is used by more people in Poland than in other EU member states; this is largely due to the perceived inadequacies of the state system.
Dental care in Poland is excellent and many people come to the country solely for dental care. It is much cheaper than in Western Europe. Some dental treatment is available through the state healthcare system, but it only covers routine visits and check-ups. Citizens must pay themselves for more detailed dental treatment like crowns and bridges.
Dispensing chemists sell medicines in Poland and only doctors and consultants can prescribe medicine. Prescription medicine is only available from a qualified and registered chemist or from a hospital pharmacy and it is subsidised through the NHF. Non-prescription drugs are priced higher than prescription drugs. Under this system, you may pay less for a packet of aspirin if it has been prescribed by your doctor. Costs for prescription drugs are reimbursed through the national health system. Medicine is more expensive in Poland than in other EU countries. There is a wide selection of over-the-counter medicines.