Evolving Choice – Corporate Social Responsibility, Simply

A Bargain Special for some but a Fundamental Breach of Principles for others?

Only introduced in January 2008 as part of a reform of the health sector, the Czech Government started requiring patients pay a fee of 30 crowns ($1.85) on each visit to their doctor. Already however, the reform has many Czechs, who see it as a matter of principle that healthcare should be free, demanding that they be repealed.

Already, the Prime Minister, Mirek Topolánek, has been brought before a constitutional court considering overturning the reforms. The court will rule on Wednesday (28/05) if the reforms contradict the constitution which explicitly states that “citizens have on the basis of public insurance the right to free medical care and free medical aids under the conditions defined by the law.”

If regional history holds, these reforms could very well be short-lived with neighbouring Slovakia and Hungary both having introduced similar reforms in recent years only to have them repealed soon after in the face of popular opposition.

In the case of Hungary, After a popular referendum where 80% voted against fees, the Parliament voted overwhelmingly (199-1) to repeal them a week later.

A victory for the people it seems but not without cost, in an immediate response to the referendum as an indicator of slowing fiscal reform, ratings agency Standard & Poors downgraded Hungary’s credit rating outlook from Stable to Negative. An outcome a Czech Republic just upgraded to an A-1 rating by the same agency would want to avoid.

Looking outside the region though, the case for opposition to these reforms can draw support from an unlikely source, China. Where healthcare reforms, which began in 1992 (when the government covered 90% of costs), have become prohibitively costly for a large portion of the country’s citizens where treatment for minor ailments costing 200-300RMB ($29-43) is not unheard of. A startling amount in Beijing where workers (in the textile or agriculture industry) earn an average of 1600RMB ($230) per month.

A situation which many Czechs, who pride themselves in their solidarity with the poor, see healthcare fee reform as a dangerous first step towards.

Maybe the world should consider healthcare reform in the image Mao’s Barefoot Doctors, after all, a common cold or an upset stomach really should not be conditions that require getting out of bed just to see a physician. Or if being treated by a minimally trained Chinese farmer is not your thing then maybe a French solution? SOS Medecins is service which provides on-call doctors round the clock who, drive to your home, diagnose you and leave you with the medication you need. Now that’s healthcare! (if only it did not cost more than $1.85)