Poland: #31 in the 2021 World Index of Healthcare Innovation
Poland’s socialized health care system ranks dead last in quality and science & technology.
By Gregg Girvan and Avik Roy
Introduction
Poland ranks dead last (31st) in the World Index of Healthcare Innovation, with an overall score of 35.52. Poland ranked last in Quality (#31, 25.23) and Science & Technology (#31, 8.40) due to its lack of patient-centered care, weak infrastructure, and low scientific impact.
The one redeeming feature of Poland’s socialized health care system is that it is reasonably stable, ranking 9th in Fiscal Sustainability (64.45); strict price controls and access restrictions keep spending growth in a manageable range — though at a substantial cost to patients.
Background
Prior to World War II, a considerable portion of today’s Poland was part of Germany, and thereby was under the German health care system first installed by Otto von Bismarck in 1883. After 1945, communists imposed the Soviet model of health care, in which health insurance and health care services were owned and operated by the state.
In 1991, after the communist government fell, Poles maintained government ownership of most hospitals and clinics, but devolved public control to the regional level (voivodeships). The National Health Fund (Narodowy Fundusz Zdrowia, or NFZ) remains the single-payer, government-run insurer.
Quality
Of all the countries in the Index, Poland ranks last in Quality at #31. Poland’s quality rankings are driven lower by all elements calculated, including measures of preventable disease (#28), patient-centered customer care (#31), infrastructure (#29), and pandemic preparedness and response (#28). In particular, Poland has among the lowest cancer survival rates in the Index, as well as some of the lowest number of primary care physicians and nurses. And wait times for specialty care is worse in Poland of any other country in the Index besides Hong Kong. A lone bright spot is Poland’s rapidly expanding economy, which could provide the groundwork for greater investment in health care.
Choice
In terms of Choice, Poland’s health care system ranks #30. While the pre-subsidy cost of health insurance is among the least expensive in the modern world, patients have only a single-payer option that impacts the quality and availability of care. In addition, physician choice is very restrictive, such that patients can only switch to a different primary care physician once every 6 months. And while innovative medicines are available on par with countries such as Sweden and Australia, such choice is hampered by little access to more affordable generics and biosimilars.
Science & Technology
At #31, Poland comes in last of the countries in the Index for Science and Technology. Development of medical and scientific innovation in the fields of medicine and biochemistry are virtually nonexistent. Poland ranks better in medical advancements (#23) because of a decent number of innovative drug approvals, by virtue of being a member nation of the European Medicines Agency. Otherwise, Poland ranks last in scientific innovation (#31) and #29 in health digitization.
Fiscal Sustainability
Despite its weaknesses, Poland’s health care system is #9 in the Index for Fiscal Sustainability. In addition to its national solvency (#11) being manageable at a 46% debt-to-GDP ratio, it has reduced its public health spending over the last 10 years.
