Health Minister Adam Niedzielski in an interview with Iwona Schymalla from Medexpress spoke about the costs of fighting the pandemic, access to e-health and control test packages.
- Minister of Health: we want to abolish the limit on access to specialists. Thanks to this, it will be possible to properly implement preventive measures
- The dominant topic of 2021 will be the plan to rebuild the health care system in Poland. «We want to act on three levels. The first is basic preventive examinations »
- The minister also wants to continue the development of telemedicine and e-health. «We are facing the greatest challenge when it comes to e-health, namely medical e-records. And this is a revolution and a Copernican revolution »- he said
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Iwona Schymalla, Medexpress: Access to medical care during the epidemic was and is very limited. On the one hand, patients wait in lines to see specialists, and on the other hand, they are still afraid to come to the appointments. In one of the interviews, you said that you are planning to implement a special program of publicly available research, including access to specialists. In what perspective will it be implemented?
Minister of Health Adam Niedzielski: Regardless of where we are in the pandemic, we must be aware that the threat to public health is not only the pandemic and coronavirus, but also certain health deficits related to, for example, the lack of prevention. (…) Indeed, from the perspective of the last six months, it must be admitted that the health deficit has increased and, unfortunately, we will have to deal with negligence in this regard. I mean both lifestyle prophylaxis and prophylaxis by tests that identify a health problem at an early stage.
This deficit relates both to the lack of disease detection and to the fact that diseases are detected at a later stage. I see the need for a general response so that we can check the state of health after the pandemic comes out and at the same time intensify efforts to persuade patients to return to research. Let’s go back to identifying and diagnosing diseases.
It certainly needs to be done, because cardiologists or oncologists already have some estimates that it may be a delayed fire bomb, that it may be other systemic costs – treating diseases in people at a very late stage.
Yes. We have a prepared offer. At the beginning, the most important issue for me was to formulate a new strategy for fighting the pandemic, because we have slightly different conditions: autumn, infections. But the second challenge is to prepare a public health recovery plan, which I would like to see as the dominant topic in 2021. The pandemic will continue, but hopefully it will end. We want to act on three levels. The first is basic preventive examinations. Public health agencies such as WHO say the pandemic has resulted in, among other things, that we gained statistically 3-4 kilograms.
What are the consequences of obesity, we all know. And we also know that obesity has grown at an alarming rate even without a pandemic. And the consequences are diabetes, cancer (which is rarely talked about), and cardiovascular and cardiovascular issues. Coming out of a pandemic, I think the most important thing is to do some basic laboratory research. We want to propose two packages. One is for men, the other for women, so that in addition to basic blood tests, everyone feels encouraged to do specific tests – for women for the thyroid gland, and for men we want to introduce PSA-based screening, i.e. regarding the possible risk of prostate. This is the basis.
The second level is the abolition of limits on access to specialists. And this is a revolutionary step that is socially expected. The consequence of the fact that we encourage everyone to do research must be to facilitate access to specialists, and such a measurable and effective measure is the lifting of the limits to all specialists. We want to do it at the level of the entire specialist. And finally, the third element of the so-called The recovery plan focuses on the three spheres of hospital treatment and more. This is oncology, which is a priority of the state and is particularly emphasized in the expose of Prime Minister Morawiecki, cardiology, psychology and psychiatry. Perhaps we do not realize how pandemic, isolation and isolation badly affect the psyche, especially of young people.
How much did it cost us to fight the coronavirus epidemic? And how much will it cost? Some people have the feeling that someone in the healthcare system will have to be taken to cover these costs.
When I was the head of the National Health Fund, working closely with the Ministry of Health, we managed to construct a system of financing the entire health, which is very safe. The starting point was the act on 6 percent. GDP for health. It is, in fact, a kind of anchor that holds and stabilizes health finances, because when it turns out that we have less contributory revenues, then the state is obliged to pay extra to the level provided for in the act. But regardless of this, we have a comfortable situation resulting from the fact that we have tools that stabilized the situation of service providers, i.e. 1/12 paid, a fixed lump sum, the possibility of applying for other support. All this meant that the financial situation of service providers in this pandemic did not worsen at all, but paradoxically improved.
In turn, when it comes to the mechanisms of stabilizing health finances, apart from 6 percent. GDP has managed to convince Prime Minister Morawiecki that in the event of a decrease in contributions, we will not only receive a larger subsidy to supplement this lack required to the level required by the act, but we also had a direct compensation mechanism for contributions that were redeemed. If we now look at the costs of fighting the pandemic, we can say that there are two types of them: direct and indirect, but all of them are financially measurable and go back to the health budget, we spent the amount of in the order of PLN 1,5-2 billion.
But, paradoxically, it turns out that this is a minority of the costs associated with the fight against the pandemic, because the compensation for the loss of written contributions amounted to approximately PLN 4 billion. That is, indeed at least PLN 6 billion went to the health sector. Please remember that what we financed in the fight against the pandemic, that is, the first one and a half or two billion, are not contributions. These are funds that were initially transferred from the outside, from the state budget, and later from the covid fund.
We have the prospect of many more months of the epidemic, so will it still look so good financially?
Instruments are maintained at all times. Also in this respect, it seems that the stability of health financing is guaranteed, and what’s more, what seems to be a comfortable situation compared to the rest of the economy, because we also have a guaranteed increase in financing, where other areas cannot count on it due to the economic situation.
See also: Durajski on Morawiecki’s words: silence was a trap
Minister, the epidemic forced all e-health solutions to be implemented fairly quickly. As the head of the National Health Fund, you introduced the e-prescription and attached importance to the development of this issue of innovation in health care. What are your priorities now when it comes to e-health?
At the Ministry of Health, I would like to continue the work started by Minister Janusz Cieszyński. We all know very well how much the Minister of Labor has done in this direction, so that we would have a certain luxury of using teleportation. Because if there was no e-prescription or e-release, teleportation would not be such a tele-advice that would have a great added value for the patient. We are now working on e-referral. Minister Cieszyński has already defined some paths of this project. But we face the biggest challenge when it comes to e-health, namely medical e-records.
This is the “Copernican” revolution and revolution. If we manage to launch an electronic medical information system, problems such as double medication registration will disappear. In fact, it will be the entire catalog, because in one place it will be possible to verify each doctor, regardless of whether we are in primary health care, in a hospital or at a specialist. This is the biggest challenge that lies ahead of e-health. I think that in addition to e-health, which really should be the foundation, we need to start taking advantage of the innovations that have emerged. I am not talking about e-services, but about the mass of devices that are used on a large scale abroad, also in private systems in Poland, and very rarely in the public system.
Please see that teleportation is not an innovation, it is a solution that has been in existence for over 20 years. And we are really glad that in 2020 you can call a doctor and talk to him. My point is that now teleportation should become a fully-fledged medical service, during which the patient can, for example, using a certified device, check his breathing and forward its recording to the doctor in such quality that the doctor will be able to listen to it and verify it on this whether the patient has respiratory problems or not. Here, the so-called startups show inventiveness, which even shows us that on the “is the limit” scale we have a wealth of innovations not used by the public system.
Since the Minister speaks about innovations, the area where they are most important for patients is the area of the entire state drug policy. We often hear that there is, however, limited access to innovative therapies in Poland, that some patients are not cared for or are on the margins of this care. How do you see the assumption of the main drug policy? Will there be an amendment to the act and what about the Medical Fund?
The editor would like to draw your attention to the Medical Fund, which is to be a tool that allows you to reach for special funds. I believe that our drug policy is to a large extent based on evidence-based medicine, which is understood not only that we have positive, verified results of this therapy, but also that we make a certain weigh-ins to the extent that the therapeutic value increases and the cost increases. And very often in this calculation (and it is carried out by AOTMiT) it turns out that these increases in therapeutic value are completely disproportionate to the increase in cost value.
When making decisions from the social point of view, when our priority is to ensure the availability of standard therapies and treatment in general, sometimes it is a better choice to buy a cheaper drug that gives a certain treatment guarantee. The most developed countries have an institutional system of verifying what appears on the market. And paradoxically, such cost accounting is not kept by underdeveloped countries, which buy everything blindly.
In Poland, we have a good institutional system that allows us to spend money rationally. So we will definitely continue this direction. We are open to the analysis of all novelties, but we do not represent the interests of pharmaceutical companies, but the public interest.
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