---

“The main sources of health expenditure in the Czech Republic are (1) SHI [Statutory Health Insurance] contributions (consisting of wage-based contributions and state contributions from general taxation), (2) state and territorial budgets and (3) private expenditure.”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

---

“In 2014, public spending accounted for 84.5% of total spending on health, with OOP [Out Of Pocket] payments and VHI [Voluntary Health Insurance] accounting for 14.3% and 0.2%, respectively (WHO, 2016).”

Source: Martin Dlouhy. “Czech Republic.” In Voluntary health insurance in Europe: Country experience [Internet]. Sagan A, Thomson S, editors. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2016. Observatory Studies Series, No. 42.

---

“Compulsory, wage-based SHI [Statutory Health Insurance] contributions are the main source of health-care financing in the Czech Republic, accounting for 74% of revenue within the SHI system in 2012 (Ministry of Health, 2013b). The remaining 26% of revenue that year came from the state in the form of SHI contributions for certain groups of economically inactive people. The SHI system accounted for 77.9% of total health expenditure in the Czech Republic in 2012 (OECD, 2014a).

“The individual health insurance funds collect the monthly SHI contributions from employers and employees, from self-employed people, and from individuals without taxable income who are not insured by the state. The General Health Insurance Fund (Všeobecná zdravotní pojišťovna, VZP) manages the redistribution of funds within the system based on a risk-adjustment scheme (see section 3.3.3). SHI contributions are legally set at 13.5% of pre-tax monthly wages (contribution base), with employees paying a 4.5% share and employers a 9.0% share. There is an annual ceiling on the basis for contribution calculation. This ceiling was increased in 2010 from 48 to 72 times the average monthly wage in the Czech Republic two years prior to the current year, which makes the funding system mildly regressive. This annual ceiling was abolished temporarily between 2013 and 2015 with the aim of mobilizing additional resources to support fiscal consolidation after the economic downturn (Act No. 500/2012). In February 2014 the government presented plans to abolish this ceiling permanently. Self-employed persons pay the same total percentage (13.5%), but the base is only 50% of their profits. There is also a legally defined minimum contribution: employees (and individuals without taxable income whose SHI contributions are not covered by the state) have to pay 13.5% of the minimum monthly wage and self-employed persons 13.5% of one half of the average monthly wage one year prior to the current year.”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

---

“Spending from state, regional and municipal budgets (not counting insurance contributions for state-insurees) accounted for 4.5% of total health expenditure in 2012 (OECD, 2014a). These budgets are financed through general taxation (see section 3.3.2). Taxes are used to cover expenditure at both national and regional levels. At the national level the Ministry of Health finances capital investments in facilities that it manages directly, such as teaching hospitals, specialized health-care facilities, specialized institutions for research and postgraduate education, and the air medical rescue service. At the regional level capital investments in regional and municipal hospitals are financed by regional authorities; it is important to note, however, that all hospitals may also apply for subsidies from the Ministry of Health. In recent years some capital investments were partially covered by EU structural and cohesion funds from the Integrated Operational Programme of the Czech Republic. The medical rescue service is subsidised by regional governments.

“The Ministry of Health provides direct financing for public health services, covering some of the costs of training medical personnel, running a variety of specialized health programmes (for example, in AIDS prevention and drug control), air emergency services, conducting medical research, and providing postgraduate education to physicians.”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

---

“Monthly wage-based SHI [Statutory Health Insurance] contributions from employers, employees and self-employed individuals are the main source of health-care financing in the Czech Republic. The contributions are collected via individual health insurance funds and subsequently reallocated among them based on a risk-adjustment scheme. SHI contributions made by the state for certain groups of economically inactive people are also included in the reallocation process. The health insurance funds serve as the main purchasers of health-care services in the Czech SHI system, and their organizational relationship with the various providers is based on individual long-term contracts.”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

---

“Although private sources of funding play only a minor role in financing the Czech health system, there was a slow but steady increase in their share of total health expenditure from the end of the communist period until 2008, when the share jumped to 17.3%. In 2008 a variety of user fees was introduced and further adjusted in the following years (see section 3.4.1). After the rise in 2008, the share of private expenditure of total health expenditure decreased to 16.4% and in the years 2010–2012 it stabilized slightly below 16%. The main private source of funding in the Czech health system is OOP spending, which accounted for virtually 100% of private health expenditure in 2012 (ÚZIS, 2013b).”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

---

“In the Czech health system the introduction of formal user fees in 2008 reduced the depth of coverage, because health providers’ remuneration was adjusted downward to take into account the revenues of user fees directly paid to providers. User fees for prescriptions and certain health services (for example, emergency care or hospital stays), as well as co-payments for pharmaceuticals, were introduced in 2008. The system of user fees and co-payments has been changed several times since its introduction. User fees for hospital stays were abolished by the Czech Constitutional Court in 2013. In mid-2014 there were user fees for doctor visits – CZK 30 (€1.20); the use of ambulatory services outside standard office hours – CZK 90 (€3.60); and per prescription – CZK 30 (€1.20). (For further information see section 3.4.1.) Co-payments other than those specified by law or top-up payments are legally prohibited.”

Source: Alexa J, Rečka L, Votápková J, van Ginneken E, Spranger A, Wittenbecher F. Czech Republic: Health system review. Health Systems in Transition, 2015; 17(1):1–165.

---

---

World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated July 26, 2023 by Doug McVay, Editor.