Czech election showdown puts health care reform under the microscope

Czech voters head to the polls on 3-4 October with healthcare firmly on the agenda. At a pre-election debate hosted by the Association of Innovative Pharmaceutical Industry (AIFP) and the Czech Chamber of Commerce, experts and candidates agreed that the system is under strain and needs fixed urgently.

Czech health spending has nearly doubled in a decade, and ageing and hospital-heavy care keep piling pressure on an already stretched system.

According to Aleš Rod from the Centre for Economic and Market Analysis, “it is absolutely essential to assess better what public health insurance funds are spent on, and to evaluate not only the price of treatment but also its benefits for patients and society as a whole.” He also urged more data use, prevention and a shift to one-day, outpatient or home care.

With 89% of public spending, business rejects higher labour charges. “There is really no room to further increase employers’ contributions, because labour costs in the Czech Republic are among the highest in Europe,” said Tomáš Prouza, Vice-President of the Czech Chamber of Commerce, adding that private resources.

Push for efficiency

Incumbent centre-right MHealth minister Vlastimil Válek (TOP 09, EPP) promised a fully digitalised, de-bureaucratized system within four years, fewer acute beds, and a stronger focus on prevention.

“By the end of the next electoral term, that is in four years, health care should and will be fully digitalised,” he said.

His challenger, Adam Vojtěch from the opposition ANO party (Patriots), who served as health minister from 2017 to 2020, argued for empowered, data-driven insurers.

“We should have active health insurance companies that will work with data on efficiency and quality and, on that basis, contract care and discuss the structure,” he said, calling for depoliticised governance.

On accountability, Válek insisted that the ministry must set rules so insurers can secure access and quality, cautioning that politicising healthcare and overturning predecessors’ policies every four years “can never lead to progress.”

Access to medicines

Both candidates backed moving suitable innovative treatments closer to patients. “One of the first steps of the new minister should be a revision of centre-based care and medicines,” Vojtěch said, arguing that many therapies are limited to specialised centres “for administrative reasons without professional justification” and prescribing should shift more to GPs.

Válek pointed to ongoing steps to expand what GPs can prescribe and to move selected centre medicines to outpatient specialists. According to the current minister, the system should ensure that “money follows the patient.” “The trend is to move oncology patients out of centres much earlier,” he said.

From the industry’s vantage point, access remains uneven despite good timelines for market entry. “It is striking that a general practitioner in our country cannot prescribe modern medicines for diabetes or cardiovascular diseases, even though this is common practice abroad,” said David Kolář, Director of AIFP. He noted that restrictive rules, the concentration of care in centres and regional disparities mean “modern treatment does not reach many patients,” prolonging illness and costs.

Prevention that finally pays off

Prevention emerged as the most credible long-term relief for an ageing society. Válek backs a “bonus, not malus” approach, pointing to expanded screening and higher prevention funds at insurers. “Last year, for the first time after ten years, 150,000 more people came for screening,” he said, while acknowledging weak vaccination rates and the need to counter misinformation.

According to AIFP director Kolář, prevention is promised in almost every government programme, yet concrete action remains thin, and vaccination coverage is still too low.

In his view, a stronger focus on public health and prevention would do the most to ease pressure on the system over time. He also argues that the next health minister faces a tough brief – Czech healthcare lacks both the courage for fundamental change and a clear direction, and unless that direction is set now, quality and access risk slipping in the years ahead.

(VA, BM)