Interviews

Jan Bodnár: Preventive care needs to be a key catalyst

Published: 8. 5. 2023
Author: Tomáš Syrový
Photo: archiv Jana Bodnára
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Human life expectancy is gradually increasing, medical devices and processes are being modernized, and that naturally leads to higher expenses for health insurance companies. We discussed the sustainability of this trend as well as other topics with Jan Bodnár, deputy director of health care at the General Health Insurance Company of the Czech Republic (VZP CR).

Let us first look back on the year 2022. What was it like for VZP? Healthcare funding was a hot topic – not only in connection with covid and later the influx of Ukrainian refugees but also a freeze of payouts for state insurance beneficiaries, and more.
It has been a rather positive year for VZP. Last year's predictions saw us closing out 2022 with losses of roughly 6 billion crowns. Now we know that the results ended up balancing out quite well, so last year went quite nicely for us in the end.

Why do you think that is?
There were multiple factors at play, to be sure. The income side of the budget was positively influenced by higher insurance fees and increased compensation for state insurance beneficiaries. And the expected negatives ultimately did not materialize. There were doomsday scenarios of additional waves of covid and subsequent expenses or Ukrainian refugees putting a strain on the system. As we can see from the data, their use of the Czech healthcare system is actually below average.

When it comes to healthcare expenses, the future outlook is a hot topic right now not just locally but the world over. Markets are constantly flooded with new drugs, state-of-the-art devices and methods, and all of that comes with a price. Can we afford that, or rather will we be able to in the future?
Making state-of-the-art healthcare accessible is a major challenge not only for the Czech healthcare system. You mentioned innovative drug products, which is one area where Czechia is doing quite well in terms of accessibility. VZP covers even the most expensive drug on the market, which is administered to young patients with spinal muscular atrophy. It was formerly a fatal diagnosis but the medicine now provides a lot of hope. There are other products where the expenses for individual clients reach not millions, but tens of millions of crowns.

But is it sustainable going forward?
It is sustainable. But we absolutely need to start implementing change ahead of time, be it in the healthcare system itself, or in the way people think about their health. Preventive care needs to be a key catalyst of this change. For that to happen, it needs to be effectively set up within the system, and also – and this may end up being ultimately much more difficult – we need to convince people that preventive care makes sense.

That won't be enough on its own, though...
We certainly need to discuss many other changes, be they minor or major, that will make the entire healthcare system better. This is essentially my daily bread now, and so I can say with full confidence that the healthcare system isn't just treading water, it's moving forward quite dynamically. To answer your question, however, I'd like to use the example of healthcare in specialized facilities, which is top-of-the-line and usually the most expensive. The gravest of diseases are treated in specialized facilities, not just cancer but also multiple sclerosis, Crohn's disease, rare diseases such as spinal muscular atrophy, cystic fibrosis, etc. When VZP started covering specialized treatments roughly ten years ago, it was confronted with exactly the worries that it may not be sustainable, that if we pay for such expensive treatments, there won't be enough funding for regular healthcare, etc. The opposite is true. Today, we cover specialized care for three times as many people as we did back then, meaning 66 thousand clients. Last year, it cost us nearly 18 billion, a decade earlier it was six. We managed to triple the volume of such care without any detriment to the coverage of less complicated or more common diseases. In other words, the worries we dealt with in the beginning turned out to be unfounded.

How do you intend to make sure that people don't neglect preventive care?
We need to come up with positive motivation for our clients. To show them just how important preventive care is for them, their loved ones, and also how it can help maintain sufficient finances for healthcare when their children may need it in the future as seniors. A shift in attitude is definitely needed to achieve that, which is a long-term mission that will take not months, but years. We've already started. The first step is the communication campaign we just launched, wherein we are using a fictitious online shop called systemshop.cz to show people what the real prices are for various procedures that can often be avoided through diligent preventive care. To provide a comparison, we also list the prices of preventive checkups. Positive motivation is another step. For instance, we offer 500 crowns of credit for a dental hygienist visit to clients who have had a checkup done by their GP in the past two years. If they have been through a cancer screening procedure in that same time window, they are entitled to a thousand crowns of credit for a sauna visit, massage, or similar convalescence activities.


VZP
The General Health Insurance Company (VZP) has been in the Czech market since 1992. It currently cares for more than six million clients.
VZP tends to its clients via a wide network of contractual partners, be they the offices of general practitioners or outpatient specialists, inpatient healthcare facilities, providers of wellness and spa convalescence services, sanatoriums, etc.
There are roughly 200 branches across the country where VZP clients can come in person for a consultation. A wide array of things can be dealt with online nowadays, primarily with the help of the My VZP app.
The company also offers a wide array of bonuses as motivation for a healthy lifestyle. Besides bonuses from the preventive care fund, these also include membership in the Good Health Club where clients can make use of various benefits primarily when buying products related to sports, weight loss, health, travel, or relaxation.
VZP intends to expend 270 billion CZK to care for its clients this year.

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