“The Velvet Revolution in 1989 led to a process of reform and democratization that had far-reaching effects on health care in Czechoslovakia and, later, the Czech Republic. The principle of free choice of health-care provider was introduced, and the huge regional and district institutes of national health that had been established during the communist era were dismantled. During the early 1990s the Czech Medical Chamber, the Czech Dental Chamber and the Czech Chamber of Pharmacists, as well as other professional medical associations, were re-established or newly founded. A new system of home care was also adopted. At the same time primary care, non-hospital ambulatory specialist care, the pharmaceutical industry, pharmacies and spa facilities were almost completely privatized.”

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 early 1990s several key laws relating to the new health system were approved, including the General Health Insurance Act (1991), the Act on the General Health Insurance Fund (1991), and the Act on Departmental, Professional, Corporate, and Other Health Insurance Funds (1992). These shifted the health system towards an SHI model, with a number of quasipublic, self-governing health insurance funds acting as payers and purchasers of care, financed through mandatory, wage-based contributions. The first such entity to be established was the General Health Insurance Fund (Všeobecná zdravotní pojišťovna České republiky, VZP), which has remained the largest health insurance fund in the Czech Republic since it began operating in early 1992. It also has the most influence due to its market share and its function as a safety net for members of health insurance funds that close or go bankrupt. In late 1992 the first of many other health insurance funds was founded. Up to 27 funds were operating at one period in the mid-1990s, but their number decreased to seven by 2014.”

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.

“An important development in public administration took place in 2003, when ownership of approximately half of the hospitals in the Czech Republic was transferred from the state to 14 newly formed, self-governing regions (see section 2.4). In the wake of this process of decentralization, some regions decided to change the legal form under which most of these hospitals operated, transforming them from entities directly subordinate to the regional authorities to joint stock companies (of which regional authorities still owned the majority of shares).

“In an effort to contain costs, a system of user fees was introduced in 2008. These fees are intensely discussed by the Czech public and the exact design of the fee system is subject to constant changes (see sections 3.4.1 and 6.1). Additionally, in 2008 the administrative structure of the regional public health authorities was consolidated, with the aim of increased economic efficiency (see sections 2.3 and 5.1). In the late 1990s research started on introducing a DRG-based hospital payment system in the Czech Republic. Since 2007 case payments based on an adapted version of the AP-DRG system have accounted for an increasing share of total hospital revenue (estimates of 55–60% in 2013) (see section 3.7).”

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.

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 Nov. 13, 2022 by Doug McVay, Editor.