Who are you treating: a growing medical crisis in Poland
The huge problems with the healthcare industry that confronted the Polish population last year have significantly worsened. The National Health Fund, in conditions of chronic underfunding by the state, has accumulated impressive debts to hospitals, and they are forced to cancel patient admissions and postpone operations for the next year. At the same time, the Polish state, clearly prioritizing, spends huge amounts of money to strengthen the army. The citizens of the country are being made to understand that militarization is more important than healthcare. Details can be found in the Izvestia article.
Catastrophic underfunding
Medicine in Poland is mainly paid for directly by taxpayers. All those residents of the state who officially work on the basis of an employment contract are subject to compulsory medical insurance. And every month, their employer transfers 9% of their income to the National Health Fund (NHS). And then this fund distributes the money it receives to all regions of the country and their medical institutions, and also concludes contracts with various medical centers.
At the same time, last year they started talking about the fact that there is a catastrophic shortage of money in the Polish NFZ. This led to the fact that the total debt of medical institutions in the third quarter of 2024 reached a record 22.8 billion zlotys (over €500 million), an increase of 400 million zlotys (over €94 million) compared to the previous quarter. This turned out to be the most significant increase since the Covid-19 pandemic, and experts sounded the alarm: "The healthcare system is on the verge of collapse!"
In October 2024, the head of the Polish Association of Employers of district hospitals, Waldemar Malinowski, announced that the National Health Fund lacked 15 billion zlotys (3.4 billion euros) to pay hospitals for medical services provided to the population. As a result, some medical institutions had to close departments and cancel or postpone some procedures until next year. Malinowski complained that hospitals in almost all of Poland received government money with a long delay or even did not receive it at all.
Moreover, the largest medical institutions also suffer from this. So, last year, the debt of the Warsaw Institute of Psychiatry and Neurology amounted to 110 million zlotys (about €26 million), so the institution had to take out a loan. In addition, numerous complaints were recorded from hospitals that did not receive money from the NFZ for services for patients provided in excess of the agreed amount. For example, one medical institution performed more MRI scans and hip replacement surgeries than originally planned, and ended up in debt because of this. And if earlier hospitals and polyclinics were not afraid to accept patients over the limit, because they knew that the state would pay them off, now they are afraid to go beyond the agreed amounts.
A year has passed, and there are more problems
Over the past two years, the number of patients in Poland waiting to see a specialist doctor has increased by 70%, and the average waiting time for a cardiologist has increased by 60%. By the summer, the budget deficit of the National Health Fund had already grown to 30 billion zlotys (more than €7 billion). Moreover, it is expected to reach 90 billion zlotys (€21 billion) by 2028. According to experts, problems with access to healthcare threaten a sharp increase in mortality in the country.
The situation is getting worse with rising salaries for health workers: 90% of the additional funds allocated by the state for medicine over the past three years have been spent specifically on increasing salaries for industry representatives. Because of this, the government has reduced the co-financing of some medical procedures from the state budget, assigning them entirely to the National Health Fund. To improve the NFZ's financial situation, it was proposed to increase health insurance contributions by 0.5% of salary. But the politicians were not yet ready to approve such a measure: they were afraid of the indignation of the workers. As a result, on the contrary, a populist law was passed in the Seimas, reducing the corresponding deductions for the self-employed.
In general, from the point of view of a simple Polish citizen, the situation with medicine is frightening. Kristina Ismagilova, a political scientist and polonist, notes: "The situation in the NFZ reflects the systemic crisis of Polish healthcare, caused by both insufficient funding and inefficient allocation of resources. Moreover, these problems have been compounded over the years. The increase in medical salaries, although necessary to retain staff, was not accompanied by adequate budget growth, which led to the depletion of the fund's reserves. At the same time, the increase in waiting lists and the deterioration in the availability of services indicate that without deep reforms, an already unstable system risks entering an absolute regression, increasing social inequality in access to medical care."
Last summer, the Polish press wrote that hospitals continue to sink into the financial abyss and the situation is only getting worse. From the point of view of the public, the government prefers to watch the medical crisis indifferently, while hospitals are suffocating under the weight of debts. After all, this year the same thing continued as in the past: reduction of procedures, closure of departments and postponement of treatment of people in need.
Social networks are bursting with indignation: users write about billions of dollars in NFZ debts for drug programs and how hospitals refuse to treat neurology and even childhood diseases such as spinal muscular atrophy. People complain that the authorities have mastered the art of promises, but not real management.
Come back next year.
In addition, in early November, news arrived that even patients with cancer began to face refusals to provide immediate care and excessive waiting, that is, those who need qualified medical care as soon as possible. This was due to the fact that by the middle of autumn, the National Health Fund had almost exhausted its financial limits allocated for the current year. Accordingly, some of the procedures had to be postponed until 2026, and panicked patients are sounding the alarm in the media. "I must say it bluntly: NFZ has gone bankrupt," Dr. Lukasz Jankowski, president of the General Medical Council of Poland (NRL), told Polsat News.
It turned out that the NFZ had not paid medical institutions for several months, and hospitals began to set restrictions themselves — and this also affected patients with serious illnesses. Now, of course, the main focus of public attention is on suspending the treatment of cancer patients, although other sufferers also have a very difficult time. For example, due to the suspension of the admission of new patients to the rheumatoid arthritis treatment program, people are informed that they will not be able to start procedures until the new year. The necessary financing will obviously appear only in 2026.
Health Minister Yolanta Soberjanska Grenda has nothing comforting to say yet. In an interview with RMF FM radio station, she admitted that "the dates of routine procedures in some hospitals may be postponed from the end of this year to the beginning of next year." According to the minister, the budget deficit in the industry reaches about 14 billion zlotys (€3.3 billion). According to Soberyanskaya-Grenda, the approval of the medical budget for next year is "in the process." And although it is planned to allocate an additional 26 billion zlotys (€6.1 billion) for medicine, this, as the minister admits, is still not enough: it needs to be taken from somewhere (that is, from the taxpayer's pocket, of course) about 23 billion zlotys more. But it will be extremely difficult to allocate such large funds, given the inflated military budget.
Dr. Lukasz Jankowski of the NRL believes that the ruling politicians are shifting responsibilities instead of solving the problem. "Instead of pouring money and helping patients, the rulers are asking who is to blame. But it is they themselves who are to blame — the politicians who have controlled healthcare for years in such a way that the system simply collapsed," the doctor exposes. According to Yankovsky, the authorities have found scapegoats in the face of doctors. He complains that propagandists serving the government tell the population that doctors "eat caviar sandwiches," but the reality, according to him, looks completely different. "We will not allow ourselves to be blamed for this crisis," said the head of the Main Medical Council.
Political analyst Maxim Reva reminded Izvestia that Poland's military spending has tripled since 2022. "In 2022, Poland allegedly spent the equivalent of €14.3 billion on defense, in 2023 - €27.3 billion, in 2024 — €32.8 billion. For 2025, Poland's military spending is already planned at €42.1 billion, which is 4.7% of the country's GDP. The state conducts large-scale purchases of military equipment, including tanks, missiles and aircraft. Naturally, it is impossible to combine an inflated military budget with sufficient funding for national medicine — Poland is not such a rich state. And the consequences of such a choice are directly felt by the common people: these are the majority of Poles who are unable to afford expensive private medicine," concludes Reva.
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