Tom Philipp, MP for KDU-ČSL, head physician of a clinic at Prague’s Thomayer Hospital, and chair of the board of the General Health Insurance Company (VZP), knows the Czech healthcare system from nearly every angle – as a physician, vice-chair of the Chamber’s Committee on Health, leader of the largest health insurance fund, and presumably as a patient as well. That made it possible to discuss a range of topics with him.
Is the state of healthcare something the outgoing coalition government can highlight ahead of the elections?
Yes, I believe there are several achievements to point to. Thanks to the automatic increase in payments for state-insured individuals, financing is now more transparent and reliable. New laws have been introduced that allow health insurers to encourage preventive care through incentive programs. We supported residency placements for young doctors in specialties facing shortages and enabled insurers to arrange cross-border care where the domestic network is insufficient. I see major progress in the development of same-day care and digitalization – for example, through the EZ card, which simplifies access to vaccination records and will allow access to all medical documentation, or eReferrals, which facilitate communication between doctor and patient. Another important change is that general practitioners can now prescribe medication for chronically ill patients – something that used to require a specialist. We launched new preventive screenings – for lung and prostate cancer, for instance – and expanded neonatal screening. And I must not forget the elimination of unnecessary administrative burdens – such as occupational health checks for common job categories 1 and 2.
Is Czech healthcare sustainable in top quality using only the current health insurance contributions?
The current financing model of Czech healthcare is difficult to sustain in the long term. The main reasons are clear: an aging population (the number of people over 85 is expected to double by 2050), a rise in chronic illnesses, deteriorating health starting from childhood, and rapidly increasing costs of modern treatments. Another major challenge is the shortage of healthcare staff – both physicians and non-physician professionals – which leads to pressure for further wage increases. If we want to keep healthcare accessible and of high quality in the future, we need to implement a number of systemic steps. First and foremost, we must significantly strengthen preventive care, which helps reduce the incidence and impact of chronic diseases. Part of care must be shifted from hospitals to outpatient and home settings, where it can be delivered more effectively – and often more comfortably for the patient. Ongoing digitalization, data use, and development of artificial intelligence in care and system management will play a crucial role. It is also essential to reassign competencies – part of the responsibility must shift from doctors to qualified non-physician healthcare professionals. And finally, we need multi-source funding with a focus on smart demand regulation to ensure the system remains truly sustainable. Without these measures, it will become increasingly difficult to maintain the current standard of care for future generations.
In Poland, for instance, voluntary supplementary health insurance is common and often included in employment contracts. Do you see this as a path for Czechia?
Drawing on good practices from abroad – especially from culturally and historically close countries like Poland – is certainly the right approach. The Polish healthcare system is based on mandatory public insurance managed by the National Health Fund (NFZ), alongside which widely used voluntary supplementary insurance exists. This model offers several advantages – such as faster access to care or greater service flexibility. At the same time, it must be assessed comprehensively, considering all key stakeholders: patients, health insurers, care providers, and the state. Other countries’ experiences can show us the way, but not all reforms that seem beneficial at first glance truly lead to a long-term sustainable and fair system. In healthcare – which touches on the health and dignity of every individual – we must avoid irreversible mistakes and take into account not only economic factors but also ethical and social impacts.
Would taxing vices like alcohol, cigarettes, sugary drinks, and unhealthy foods – and directing those funds into the healthcare system – be a viable path? Why has it been possible to tax fast food and sugary sodas in Slovakia and Hungary, but not here?
Taxing so-called vices – alcohol, cigarettes, sugary beverages, and generally unhealthy foods – definitely has its place in the healthcare debate. It can bring additional revenue to the system and has an educational effect – discouraging behaviors that lead to illness and thus higher treatment costs. However, this path is not as simple as it seems. We must ensure that tax hikes do not merely encourage the black market – which can happen quickly, especially with alcohol or tobacco. In such cases, the effect is completely nullified. In the Chamber of Deputies, for example, we're currently testing how a restriction on children’s access to energy drinks might pass. And let me tell you – it’s chaos. There are many opinions, some perhaps "influenced in various ways," and getting it through is very difficult. I remember when we, along with Minister Němeček, pushed for mandatory warning images on cigarette packaging to highlight health risks. It was a tough battle, but in the end, we succeeded – and now no one questions it. Slovakia and Hungary have shown that taxing sugary drinks or fast food is possible. In our country, the political climate hasn’t matured yet, but the debate is ongoing. If such a measure can be well-targeted, with clear health benefits and reasonable regulation, it may be the right path. But it must not be just about collecting revenue – the goal must be better public health.
In Slovakia, there's a debate about how much the state values a human life in terms of spending on medicines and treatment. Should Czechia have a cap on healthcare spending per patient?
The Czech system already uses mechanisms that assess the cost-effectiveness of treatment with regard to clinical benefits and economic impact. The State Institute for Drug Control uses a so-called willingness-to-pay threshold, set at 1.2 million CZK per QALY (Quality-Adjusted Life Year). This value serves as a reference point when evaluating whether a new treatment is cost-effective. In practice, this means that if the cost of obtaining one QALY through a new treatment does not exceed this threshold, the treatment is considered cost-effective and may be covered by public health insurance. I do not consider the introduction of a fixed, unchanging spending cap on treatment appropriate. Healthcare must remain flexible – every patient and every diagnosis is different. Allowing individual expert assessment – especially in cases of rare diseases or innovative therapies – is, in my view, key to ensuring a fair and modern system.
In Czech politics, proposals to legalize euthanasia keep surfacing. Is this debate appropriate, especially given the increasing availability of palliative care?
During my medical career, I have repeatedly encountered people in extremely difficult life situations and with serious, often incurable illnesses. I therefore understand why euthanasia is a topic of discussion in Czech society and politics. Still, I would not support its legalization. I believe it would not only contradict the respect for the inviolability of human life, but would also carry significant risks of abuse – despite any legislative safeguards. These risks have not been fully eliminated in any country where euthanasia has been legalized. In my view, the right path is to maximize support for accessible, high-quality palliative care (which I also actively worked on as deputy minister). This care can offer patients and their loved ones dignified conditions in the final stages of life, alleviate pain and suffering, and preserve human dignity. Equally important is providing support for caregivers of terminally ill patients – ensuring they have the necessary infrastructure, professional help, and emotional support. Shortcuts may seem attractive, but they carry great risks – not only for the patient but also for their family. And in moments like these, we must act with the utmost caution and respect.
The author is a European editor of Deník
CV BOX
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 (VZP), member of the Prague 12 Municipal Assembly, and former vice-chair of the KDU-ČSL.
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 deputy minister of health for four years. From late November 2018, he worked at Agel, a.s., as the first vice-chairman of the board and director of the Jeseník Hospital. He never fully severed ties with Thomayer Hospital and eventually returned there full-time.
He has been a KDU-ČSL member since 2002 and an MP since 2021. After eight years of serving as a member of the VZP board of directors, he became its chair in February 2022.
Philipp lives in Prague. He is married and has five children. He enjoys hiking, cycling, cynology, and fishing. Politics remains his primary hobby, however.
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