On the last day of February, MP Tom Philipp was elected chairman of the Board of Directors of the General Health Insurance Company (VZP in Czech). Four days after the Russian forces invaded Ukraine. These events impacted not only his professional life but also his personal one.
You became the chairman of the VZP Board of Directors at the very moment when a wave of Ukrainian refugees flooded Czechia. I assume that the vast majority of them signed up at VZP...
Yes, the majority of them are registered with VZP. It is due to the VZP’s resilient reaction to the crisis, and I have to give thanks to the management and of course all of our colleagues at the various branches. We placed our staff at all the regional assistance centers and they were registering the refugees right away. And so, the majority of them ended up in our care, which has another added bonus – that all matters are now centralized to some degree. When a doctor sends out invoices, they do not have to invoice each insurance company separately but can send it to the same one for all the patients. And we are happy to take care of them. I became personally acquainted with how the centers worked because we have four Ukrainians at home, two mothers with their children. I drove two of them to the Congress Center myself, and it was interesting to see that they wouldn’t even let me in. That is how strict the security measures were. They had to go in on their own, but a volunteer who spoke Ukrainian was with them right away, she explained all the particulars and showed them where to go. I thought they would be there for at least ten hours but in the end, they called me less than five hours later to tell me that I can come and pick them up. They were very pleasantly surprised by how smooth the whole process was.
How did you happen to take them in?
We have a head physician at our hospital who is Ukrainian so I asked him to put me in contact with refugees in need. He got back to me within a week and there they were. My wife and I did not even think to not help out, I am absolutely and unequivocally in favor of helping women and children who were forced to flee. I consider them to be heroes who travelled to another country to protect their children, and I consider their husbands to be heroes because they are making sure that we remain in relative safety, they are fighting for us as well to a certain degree. But many other families have decided to help out the same as we have, so we do not consider it anything special. We have two bedrooms in our house that are empty after our children left and a bathroom right next door, so they have everything they need. They have been with us for over three months and it has been a nice, symbiotic relationship. Almost as if we were having family over. The communication is an amalgamation of Czech, Ukrainian, and Russian with some English words sprinkled in but we have gotten used to each other and it is quite nice.
Let’s talk about VZP itself. This autumn, there will be negotiations about the level of reimbursement for state insurance beneficiaries in the upcoming year. What is your agenda, seeing as you are in a conflicting twofold role – chairman of the VZP Board of Directors but also a Member of Parliament?
Things aren’t easy, I admit. [laughs] What’s more, it is not a two- but rather a threefold role because I am also a doctor. And as a doctor and hospital manager, I also understand the side of the providers. I see the insurance company side of things too – trying to achieve stability as well as its own goals. And then I am faced with the role of an MP who has to keep the state budget balanced. What I really see it as is a challenge. The matter of healthcare reimbursement for 2023 was discussed all spring this year as part of the conciliatory proceedings. Accord was not reached on all the different healthcare segments, however. The Minister will be faced with the difficult task of drafting a balanced reimbursement decree, likely one of the most difficult challenges of his year. He has to allocate funding evenly to make sure that no segment is suppressed and has to make do with the funds he is given. On top of that, the pressure to increase reimbursement due to inflation will be high. There are ongoing talks about the regular valorization of coverage, which could help our healthcare become more stable. After all, this is something we have been trying to achieve for maybe 20 years. So far, we have agreed that it will be done similarly to the valorization of pensions, meaning adding up percentual inflation growth and 50 percent of real wage growth. And the sum total will be the upward adjustment of state insurance reimbursement. In our coalition, we have also established the starting amount for 2023, which will be CZK 1900 per month per person. Now we have to push this concept through in the Chamber.
You have been on the VZP Board of Directors for eight years now. Have there been significant changes in the VZP or, more broadly, in insurance companies in general?
When I joined the Board of Directors, which was back during my time as deputy minister, VZP was running a deficit of roughly CZK 1.5 billion. There was nothing in the surplus fund, any remaining money that was left in the operation fund and other such vehicles went towards paying down that debt. So the company was in very dire financial straits. Things have changed dramatically. Looking at health insurance companies in general, when I was leaving the Ministry, which was about five years ago, they were roughly 25 to 30 billion in the black. This January, all health insurance companies had a combined surplus of roughly 52 billion. In general, it could be said that their reserve funds are full, they are running a surplus on their operation funds, and have sufficient amounts left in their capital funds. I would say that health insurance companies have been doing quite well these past eight or nine years, despite Covid, now the war in Ukraine, and an inflation crisis to top it all off. To keep this trend going will be increasingly difficult, however.
The new government has taken over at a very inopportune time indeed...
True. The times are extremely turbulent. And those who are at least partly responsible for inflation are now giving us a hard time. But that’s just politics. [laughs] The previous government had COVID-19, we have war and unprecedented levels of energy prices and broad inflation.
Speaking about Covid – many people now see it as just another flu strain, but then some epidemiologists are warning us that things will get worse come autumn. Where do you fall?
Repeating the past mistakes of the previous government and its ministers would be costly. I mean not being prepared for a possible worst-case scenario in autumn. That is why we have been advising people to hold off on their potential booster shots until August or September to make sure they have as many antibodies as possible in autumn. There should be some sort of educational campaign to explain to people that whoever wants to be sure they will not have a bad case of Covid should get vaccinated in the aforementioned period.
Doctor, MP, Chairman of the VZP Board – do you get any free time? You once talked of cycling, fishing…
Well, that’s no longer possible. [laughs] But I don’t think it is a bad thing. I feel that life should be an adventure. And if the adventure is to be meaningful, it shouldn’t just be an adventure for the sake of adventure. For me, the adventure is my work, and it certainly has meaning. A lot of good things can come to fruition if we manage to correctly implement valorization, for instance. I also have some ideas for legislative changes – our market has recently seen an influx of nicotine pouches, which are being abused by young children. The law did not see as far, and we need to make some changes. It’s often just little things, nothing revolutionary for society, but it can perhaps nudge it in the right direction. So I view my work as an adventure. And a nice one at that.
Tom Philipp (born December 26, 1968, in Prague) is the head of the Rheumatology and Rehabilitation Clinic of the Third Faculty of Medicine at the Charles University and the Thomayer University Hospital, MP, chairman of the Board of Directors of the General Health Insurance Company, vice-chair of the KDU-ČSL, and former deputy minister of health.
Following his graduation from the Second Faculty of Medicine at Charles University in 1993, he started working as a physician at the Rheumatology Ward in the Thomayer Hospital, later becoming the deputy director (2005-2014). From 2014, he worked as a deputy minister of health for four years. "Then came Adam Vojtěch and the ANO, and they dropped a lot of people at the different ministries," says Philipp.
In November 2018, he started working at Agel a.s. where he was appointed first vice-chair of the board and director of the Jeseník Hospital. “It was a very interesting time in my life, I learned a lot, both as a person and as a manager,” he says.
Philipp always maintained ties with the Thomayer Hospital to some degree and eventually came back full-time. He is married and has five children. He enjoys hiking, cycling, cynology, and fishing. Politics remains his primary hobby, however.
What does the position of Chairman of the VZP Board of Directors entail? Does it come with executive power? “Certainly not,” says Tom Philipp. “The authority of the Board of Directors is clearly defined in the rules of procedure. It definitely does not have a say in executive matters. What it does do, however, is manage and supervise the financials and operations of the insurance company. There are monthly meetings where company management presents last month’s results. The Board has to approve large-scale contracts, various conceptual plans, yearly reports, it is that kind of work. Executive power, meaning the chairman or other members giving orders, is not something it has. It is a joint body comprising 30 people, so the chairman does not just get to decide on their own. They direct the Board but they have a single vote, same as everybody else.”