From research: Czechs want socially sensitive changes in healthcare

The majority of the Czech population is aware of the severe problems facing the country’s healthcare system and recognizes the need for swift reform. People most commonly complain about long waiting times for appointments with outpatient specialists and for planned procedures in hospitals. Moreover, most of the public believes that Czech healthcare has not improved in any way over the past five years. This is an alarming outcome, given that healthcare spending increased by more than CZK 250 billion during this period.

These findings come from the research study Healthcare Through the Eyes of the Czech Public, conducted in collaboration between the Health Insurance Bureau (KZP) and the National Association of Patient Organizations (NAPO).

The research was carried out by the GEN Agency from the Faculty of Informatics and Statistics at the Prague University of Economics and Business (VŠE), with data collection managed by the research agency ResSolution. The study was part of the Healthcare 2030+ initiative, supported financially by the EU Flash Horizon project and the companies Roche and Takeda.

A representative sample of the Czech population provided not only their views on the current state of healthcare but also their attitudes toward potential future changes—ranging from higher co-payments to reducing the number of hospitals.

“There has been a lively expert debate for some time now about how to reform Czech healthcare and preserve access to modern care for all residents. Articles on this topic are published in the media every week. Yet, political parties remain silent on such a critical issue. We hope that politicians will use the findings of this research to shape their election programs for the upcoming parliamentary elections. There’s no time to waste,” says Robert Hejzák, chairman of NAPO.

“The public offers a clear guide for policymakers in this research, highlighting where they should direct their efforts. Its findings provide valuable insights for responsible planning of changes that could enhance the efficiency and sustainability of the system without compromising its accessibility for citizens,” adds Ladislav Švec, director of the Health Insurance Bureau (KZP).

High Demand for Structural Changes in Healthcare

Eight out of ten respondents believe that reforming the current healthcare system is essential. Most of them (81 %) favor immediate changes, while the remainder (19 %) lean toward gradual steps over the next decade. Women, who generally show greater interest in healthcare and similar issues, are particularly supportive of a swift start to structural reforms.

Discussions about reform inevitably raise the question of whether and which of today’s common standards people would be willing to forgo. The majority rejected proposals such as limiting the number of clinics and hospitals, which would increase travel distances to healthcare facilities (71 %), or extending waiting times for non-urgent cases (73 %). The findings indicate a public preference for socially sensitive changes—83 % of respondents opposed the idea that patients should pay for expensive care costing over CZK 10 million annually out of pocket.

On the other hand, most respondents (70 %) support financial incentives for those who adopt a health-conscious lifestyle. This form of motivation is particularly favored by university-educated individuals (85 %) and those over 65 years old (84 %). The second most acceptable solution is the option to choose between various insurance offers based on premium levels (supported by 51 %). A relatively high level of support (40 %) was also observed for the idea of patients covering low-cost care up to CZK 1,000 themselves.

People Are Most Concerned About a Shortage of Doctors

From a demographic perspective, the near future poses several threats that could significantly impact the Czech healthcare system. Respondents overwhelmingly identified a shortage of doctors and medical staff as their primary concern (50 %). This was followed, at a considerable distance, by fears of financial shortages (13 %) and a lack of medicines (12 %). Conversely, approximately one-third (32 %) were unsure about potential problems or did not anticipate any issues. Awareness of the challenges facing healthcare is particularly high among people with higher education levels.

The shortage of doctors also ties into the most commonly experienced issues people face when accessing healthcare today. The majority (51 %) complained about waiting times for outpatient specialists, and 45 % expressed dissatisfaction with delays for planned procedures in hospitals.

Many Struggle to Find Positives in Healthcare

Participants in the study rated the Czech healthcare system with an average score of 2.77 (on a scale where 1 is the best and 5 the worst). Younger generations expressed greater satisfaction, while older working-age adults up to 64 years gave a harsher score of 3.07. Similarly, patients with chronic illnesses and their caregivers were more critical in their evaluations, assigning scores of 2.89 and 2.84, respectively.

The research revealed that there are few aspects of Czech healthcare that the public appreciates. The most frequently mentioned positives were technological equipment and the expertise of medical staff (30 %), followed by the accessibility of healthcare services (18 %) and the quality of care combined with staff willingness (16 %). These are relatively low numbers, and nearly one-fifth of respondents could not identify anything worth praising.

Despite Entitlement to Free Care, People Are Becoming Accustomed to Paying

Among the positives of Czech healthcare, the free access to healthcare services was mentioned by only 16 % of respondents. It’s not surprising that this number isn’t higher. The research revealed that a significant portion of the population (46 %) frequently encounters requests for payments for services covered by insurance. The most common charges are for single-use medical materials (19 %), which are mostly paid by women. Respondents also reported other, more problematic payments related to higher comfort and better materials (15 %) or registration fees at doctors’ offices (15 %). Alarmingly, some patients are forced to pay for routine administrative tasks, such as online appointment bookings (5 %), receiving care at the scheduled time (4 %), or even preferential treatment (2 %).

The full study with the research findings is available for download at bit.ly/KZP-NAPO-studie.

Initiative Healthcare 2030+: https://koncepce.kancelarzp.cz/o-nas

Patient Vision for Healthcare 2035: https://silapacientu.cz/vize2035