OVERVIEW OF CZECH REPUBLIC’S NATIONAL HEALTHCARE SYSTEM

Population Insurance Coverage For A Core Set Of Healthcare Services (%) (2017):
Public Coverage: 100%; Primary Private Health Coverage: 0%; Total: 100%

Note: “Population coverage for health care is defined here as the share of the population eligible for a core set of health care services – whether through public programmes or primary private health insurance. The set of services is country-specific but usually includes consultations with doctors, tests and examinations, and hospital care. Public coverage includes both national health systems and social health insurance. On national health systems, most of the financing comes from general taxation, whereas in social health insurance systems, financing typically comes from a combination of payroll contributions and taxation. Financing is linked to ability-to-pay. Primary private health insurance refers to insurance coverage for a core set of services, and can be voluntary or mandatory by law (for some or all of the population.”)”

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

Annual household out-of-pocket payment, current USD per capita (2018): $251

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed Jan. 14, 2021.

Out-of-Pocket Spending as Share of Final Household Consumption (%) (2017): 2.3%

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

Remuneration of Doctors, Ratio to Average Wage (2017)
General Practitioners: NA
Specialists: 2.4

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

Remuneration of Hospital Nurses, Ratio to Average Wage (2017): 1.2
Remuneration of Hospital Nurses, USD PPP (2017): $32,900

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

“The health insurance funds in the Czech Republic are quasi-public, self-governing bodies that operate primarily under public law. The funds are not permitted to make profits and are open to any applicant who is legally entitled to health insurance in the Czech Republic; any kind of risk selection or creamskimming is not permitted. Although all of the health insurance funds serve fundamentally the same purpose, the VZP [General Health Insurance Company of the Czech Republic] as the largest one differs from the others in terms of its role and, to a certain extent, its organizational structure and governance.

“Two important features distinguish the role of the VZP from that of the other funds. First, its solvency is explicitly guaranteed by the state; as such, it functions as a safety net for members of health insurance funds that close or go bankrupt. Second, the VZP manages the special central account used for reallocating SHI contributions according to a risk-adjustment scheme (see section 3.3.3).

“The VZP also differs from the other health insurance funds in terms of its organizational structure. Because of its size, it has 14 regional branches as organizational units, one in each region of the Czech Republic. In contrast, some of the other health insurance funds are relatively small and do not operate on a nationwide basis, although they are free to expand if they so choose. An example of one of the smaller funds is the Škoda Employee Insurance Company (Zdravotní pojišťovna Škoda), which had nearly 140,000 members in 2012 (Chamber of Deputies, 2013).”

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.

“Participation in publicly financed health coverage is compulsory for all permanent residents and people working in the Czech Republic. Health insurance funds are autonomous public organizations that collect contributions from their members and purchase health services on their behalf. The largest public insurer is the General Health Insurance Fund of the Czech Republic, which enrols about half of the population. Seven other health insurance funds cover the rest of the population. The government pays contributions on behalf of economically inactive people (children, students, unemployed people and pensioners).

“Migrants from outside the EU who are not employed (children, pensioners, students or the self-employed) are excluded from publicly financed health coverage. The law requires that they are covered by their home country or purchase private health insurance covering basic health care benefits.

“Before 2008, people only paid user charges for prescription medicines. In 2008, the government introduced the following user charges: Czech koruna (CZK) 30 (about €1.2; the average exchange rate in 2008 was €1=CZK 25) for each outpatient visit; CZK 30 (€1.2) for each item on a prescription (changed to CZK 30 per prescription in 2012); CZK 60 (€2.4) per inpatient day (raised to CZK 100 in 2011); and CZK 90 (€3.6) for emergency services. There is a yearly cap on some user charges.”

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.

“VHI [Voluntary Health Insurance] plays two roles: a substitutive role for nonemployed foreigners (migrants) from non-EU countries and a supplementary role providing access to above-standard hospital rooms and dental services. In addition, insurers offer (under the misleading name of private health insurance) policies that cover cash benefits in case of illness or hospital admission. There are also insurance policies that cover the costs of acute care abroad for people travelling outside the EU. These types of policies are not described here.

“The role of substitutive private health insurance for foreigners has increased as the number of migrant workers from non-EU countries has grown – for example, in October 2012, there were 104 438 migrants from Ukraine and 56 623 from Vietnam (Ministry of the Interior of the Czech Republic, 2015) – and with stricter control of the possession of health insurance by immigration police. A valid health insurance policy is a legal requirement for a long-term residence permit. The number of migrants with private health insurance is not known and there are many foreigners who do not have either public or private health insurance. These people usually work without a formal job contract.”

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.

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 several other nations.

Page last updated Sept. 20, 2021 by Doug McVay, Editor.