From 12 January, free access to a general practitioner, even for those who do not appear in the register as paying health insurance contributions to the Social Insurance Institution, guarantees us a new provision from January XNUMX. How does it work in practice?
The idea was that medical assistance would be provided to everyone who is entitled to health services, although the eWUŚ system does not confirm this. The Ministry of Health points out that the regulations are intended to eliminate situations where patients who were entitled to benefits did not use healthcare for fear of incurring costs.
Medonet wrote about it on January 4, 2016 in the text “Free doctor for liars?”
– The experience so far shows that the vast majority of patients, who are not confirmed by the eWUŚ system, are people who have a potential right to insurance benefits and have not been registered for health insurance – says Milena Kruszewska, spokeswoman for the Ministry Health.
This applies, for example, to students who have not been registered for insurance by their parents. Pursuant to the new regulations, they will be able to register for insurance retroactively.
Unfortunately, as reported by Gazeta Wyborcza, if an uninsured person admits that they do not pay contributions, the doctor will admit them, but for money; if, on the other hand, they lie that they have insurance – then the visit will be free.
– I do not persuade anyone to speak untruth – comments the health minister Konstanty Radziwiłł, but Mielna Kruszewska for MedTvoiLokona adds: “As a result of the solutions adopted, it may happen that a person who consciously confirms the untruth by submitting a declaration on the right to healthcare services ».
Doubts about the new regulations are also raised by the Agreement of Healthcare Employers. At the end of December, the organization asked the ministry to clarify the method of financing services provided by a primary care physician and to define the rules of procedure and functioning of this change. Doctors ask, inter alia, who will verify prescriptions issued by a GP to uninsured persons (according to the regulations, these patients will have to bear the full cost of purchasing the drug). The PPOZ also asked who would bear the costs of diagnostic tests of these patients, and whether doctors would be able to refer them to the hospital.
The data from the National Health Fund show that in 2013-2015, almost 13 zlotys were spent in administrative proceedings (conducted with reimbursement of costs). administrative decisions in the amount of over PLN 22 million. In the case of health care services, the value of these decisions is PLN 1,2 thousand. zloty.
Paradoxically, this “minor” fraud is to be more profitable for the ministry than financing benefits for an unauthorized person.