Czech government passes game-changing healthcare amendment

The Czech government has approved an amendment to the Public Health Insurance Act that could be a game changer for Czech healthcare.

The law will enable health insurance companies to allocate significantly more funds toward disease prevention, enhance benefits for insured individuals, and broaden coverage options, including certain types of dental care.

The amendment, set to take effect in 2026, also allows for payments for certain treatments abroad and strengthens oversight of insurance companies. Minister of Health Vlastimil Válek announced that the bill's first reading is expected by the end of the year.

“We are granting health insurance companies much greater flexibility to create incentives for policyholders who actively manage their health. They will be able to allocate up to six times more funds than they currently can,” Válek said, noting that insurers can presently use up to CZK 15 billion of the roughly CZK 500 billion within the public health insurance system.

The amendment also redefines the roles, rights, and responsibilities of health insurance companies. “The responsibility of insurance companies is now more clearly defined,” said Válek. “Every Czech citizen is insured not by the Ministry of Health but by their specific health insurance provider,” he explained, comparing the system to car insurance, where claims are managed by insurance companies rather than government ministries.

The law also introduces changes to insurance company reserves, replacing mandatory reserve funds with funds dedicated to beneficial activities. Through this provision, insurers can support regional scholarship programs for doctors, improve healthcare access, and fund patient organizations, according to Válek.

In addition, the amendment permits health insurers to contract with foreign healthcare providers, expanding the range of treatment options for patients.

The amendment has been under discussion since April, and some proposed provisions—such as requiring patients to cover damages caused to their health due to criminal acts—were removed after debate.

The last major amendment to this law, introduced by former Health Minister Adam Vojtěch in 2020, primarily addressed funding for high-cost medications and faced delays due to the Covid-19 pandemic. Válek expressed optimism that his amendment would be well-received across health committees without obstruction.

The Czech healthcare system currently faces several challenges, including long waiting times for treatments, limited access to certain specialized care, and regional disparities in healthcare availability. Many patients struggle with high out-of-pocket costs for services not fully covered by insurance, leading to financial strain and delayed care.

The new amendment is poised to address these issues by increasing funding for preventive care, which can help reduce the overall burden on the healthcare system by addressing health issues before they become critical.