AmCham EU health care visit in Prague focused on the fundamental balance between European, national and local governance

Will one of the long-term consequences of COVID be the Europeanization of health care provision? How can the shift from very defined (and well-defended) national systems improve patient care? Does it represent a very major shift in the government of Europe? While AmCham EU's four sessions with Czech policymakers did not address these questions directly, the fundamental balance between European, national and local governance never lay very far beneath the surface.

The visit began with an excellent overview of how the Czech health system is financed by MUDr. Pavel Hroboň, M.S., Director of the Advance Healthcare Management Institute. The system increasingly relies on general tax revenue to fund its activities. That promises to stir debate as fewer funds are available for other areas of government.

The EU has stepped in with funding of its own (though ultimately this funding will be paid either by national taxes or EU taxes on citizens and companies). The EU has earmarked money for improving cancer care and as part of its Covid recovery initiative. This has led to a new National Cancer Plan, which establishes some measurable targets and identifies investments to achieve that target. The Czech Oncology Society has proposed a new center for oncology at Motol to handle all the complicated cancer cases in the country. This scaling of care has been implemented in other countries to increase the quality and efficiency of care by concentrating experts and equipment. The possibility raised by the EU's move into health care is whether scaling should be limited by national borders. Could Czechia become the center for advanced oncology for all Central Europe?

Moving care across national borders would require a more coordinated approach to patient data than exists today (a subject discussed often in our sessions). From an economic perspective, patient information is powerful tool to prevent competition. Whoever possesses it controls the tax revenues for caring for that patient. The free flow of patient data within a system means that funding will flow to the doctors and hospitals providing the best care. You can test the commitment to quality care by measuring the interoperability of systems for handling patient data.

The EU wants to apply the principles of the Common Market on pharma products (and this should be seen as a wedge for imposing these principles on health care in general). EU officials could centralize public procurement and unify market access across the EU. Scaling benefits when it provides an efficient, common standard. The question is what the least common denominator should be, and how much each country can supplement this.

We would like to thank Mgr. Jakub Dvořáček, MHA, LL.M., Deputy Minister of Health, Mgr. Irena Storová, MHA, Director of SÚKL State Drug Control Authority, MUDr. Alena Miková of VZP health insurance company, PhDr. Karel Hejduk, Director of the National Screening Center at the ÚZIS Institute of Health Information and Statistics of the Czech Republic, Ministry of Health and the National Screening Center scientific head RNDr. Ondřej Májek, Ph.D., prof. MUDr. Miloš Táborský, CSc., FESC, MBA, Director of the National Telemedicine Center, Olomouc hospital, MUDr. Richard Pikner, Ph.D., Pilsen Region Councillor, Klatovy hospital, and Mgr. René Samek, MA, Msc., Life Sciences, CzechInvest government agency for their insights!