When I was paid less as a young doctor for night work than when I worked in the same department a few years earlier as a medical student and temp, I considered it a colossal injustice. Since then, we have experienced various and numerous protests over health workers’ incomes. The Medical Trade Union Club was formed and rebelled against Klaus’s squirming, the Czech Medical Chamber later became the engine of the Thank you, we’re leaving event. At that time, ministers Heger and Kalousek stood against it, and all in all, the doctors received more promises than real support.
Now another medical generation has come. She told herself that she just wanted less work and more money, and to my surprise, she really did. In the 12 years since the last major event, however, not only doctors have changed, but also politicians. This time they are different, and they give out of the common far more easily than it used to be in the past. However, from a medical point of view, this step brought about a kind of straightening of the European standard in remuneration. So far, everything is fine, and Dr. Práda and his colleagues have achieved something that the generations of his predecessors have never managed to this extent.
However, from the doctor’s point of view, let’s now move to the point of view of the citizen of the Czech Republic, who respects doctors and long-term respects them the most out of all professional groups. Just to remind you – nurses, teachers and scientists are also consistently at the top of the respective rankings. It must be said that they are not talked about as much by the remuneration parties, and if doctors deserve higher salaries, why not others? It even turned out that today there are places in education where the basic income does not even reach the minimum wage, and directors subsidize them additionally from their budgets. This is actually the same shame as the post-revolutionary remuneration of young doctors.
The question now is why the government finally backtracked on its original positions, with the prime minister saying that he would not pour any more money into the health sector. So where did the funding for the health workers ultimately come from? According to the provisional statements of all actors, it seems that from health insurance. To clarify, this is just a tax with a different name, which the state imposes on citizens and itself in order to ensure the financing of health care. In other words, it is money for health care that will be used in the system either by giving it to health professionals or otherwise be used in the patient care system.
And this way of using state funds without simultaneous reform of the entire system means nothing more than that we spend more money instead of treating our patients for it. To be clear, it is not at all that I am criticizing the move to increase PhD salaries. I just want to draw attention to the fact that if the costs are not compensated by savings or rather higher efficiency of the system, then we are just continuing the crazy ride of recent years. At the same time, we are slowly getting used to deficits in the hundreds of billions, and political elites shamelessly give away for their future success without introducing systemic reforms.
I would also like to point out one important fact. In a certain Czech fairy tale, it is said that what hell takes, it does not return. In a sense, this is also true of all salary increases, but even more so of political influence. At this moment, we are witnessing that the prime minister, armed with the entourage of the head of the largest health insurance company, will decide where the money collected for the care of the sick will be allocated, and so it will happen without delay. We can infer that political control over half a billion crowns in the Czech healthcare system is absolute.
Everyone inside the system has known this for a long time, but the other citizens of the Czech Republic could not have received a clearer message than this one. We all live in a system in which a small group of people controls and distributes huge state-collected funds without any qualms about using them for their own political goals.
This is the reality of state-run healthcare. Healthcare, in which reforms have only been talked about for decades, the system is criticized, but the changes are only cosmetic. The most likely reason for reluctance to change is precisely that the people with the greatest influence on decision-making are actually comfortable with this situation. Recent experience clearly shows why.
The winners, i.e. Dr. Přád and his colleagues, should be congratulated. And to the losers, i.e. to all current and future patients and clients of the Czech healthcare system, congratulations. To wish that someone will finally be found whose goal will be something more than just a reaction to the political initiatives of disgruntled and well-organized groups of citizens.