Kl\u00ed\u010d ![\"insurance-911819__180\"](\"https:\/\/www.pacienti.cz\/wp-content\/uploads\/2015\/08\/insurance-911819__180-150x150.png\")
<\/a>k n\u00e1prav\u011b financov\u00e1n\u00ed ve\u0159ejn\u00e9ho zdravotnictv\u00ed<\/span><\/strong><\/h1>\n <\/p>\n
Na co mus\u00ed m\u00edt ve\u0159ejn\u00e9 zdravotn\u00ed poji\u0161t\u011bn\u00ed pen\u00edze<\/span><\/strong><\/h3>\n <\/p>\n
\u00dastava \u010cR ukl\u00e1d\u00e1 st\u00e1tu, aby zaji\u0161\u0165oval dostupnost zdravotn\u00ed p\u00e9\u010de pro ka\u017ed\u00e9ho ob\u010dana. Jde o rovn\u00fd p\u0159\u00edstup k pat\u0159i\u010dn\u00e9, to jest \u00fapln\u00e9 a kvalitn\u00ed p\u00e9\u010di,\u00a0 jak to bl\u00ed\u017ee ur\u010duj\u00ed dal\u0161\u00ed z\u00e1kony vy\u0161\u0161\u00ed pr\u00e1vn\u00ed s\u00edly. St\u00e1t odpov\u00edd\u00e1 za fungov\u00e1n\u00ed ve\u0159ejn\u00e9ho zdravotnictv\u00ed<\/strong>, schopn\u00e9ho poskytovat garantovanou p\u00e9\u010di kvalitn\u011b a hospod\u00e1rn\u011b.<\/p>\n\u00dastava \u010cR tak\u00e9 stanov\u00ed, \u017ee tato p\u00e9\u010de se p\u0159\u00edmo neplat\u00ed, hrad\u00ed se solid\u00e1rn\u011b z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed, co\u017e pro st\u00e1t znamen\u00e1 z\u0159\u00eddit a m\u00edt pod kontrolou ve\u0159ejnou zdravotn\u00ed poji\u0161\u0165ovnu<\/strong>.<\/p>\n <\/p>\n
Na soukrom\u00fd subjekt nelze odpov\u011bdnost za pln\u011bn\u00ed \u00fastavn\u00ed povinnosti p\u0159en\u00e9st. Z\u00e1kon sv\u011b\u0159uje ve\u0159ejn\u00e9 zdravotn\u00ed poji\u0161\u0165ovn\u011b\u00a0 hospoda\u0159en\u00ed s ve\u0159ejn\u00fdmi prost\u0159edky<\/strong>, kter\u00e9 mus\u00ed b\u00fdt pou\u017e\u00edv\u00e1ny hospod\u00e1rn\u011b. To se\u00a0 nejl\u00e9pe poda\u0159\u00ed, kdy\u017e je<\/strong> poji\u0161\u0165ovna jen jedna<\/strong> a p\u0159esn\u011b pln\u00ed z\u00e1kon. Pluralita poji\u0161\u0165oven zv\u011bt\u0161uje provozn\u00ed n\u00e1klady, kter\u00e9 p\u0159i jedn\u00e9 poji\u0161\u0165ovn\u011b mohou b\u00fdt pod 3% obratu, v zem\u00edch s rozvinutou pluralitou je to i v\u00edce ne\u017e 6%. V \u010cR by to bylo asi 10 miliard K\u010d za rok, stejn\u011b jako zv\u00fd\u0161en\u00ed st\u00e1tem placen\u00e9ho pojistn\u00e9ho o 210 K\u010d m\u011bs\u00ed\u010dn\u011b. Pluralita tak\u00e9 zp\u016fsobuje probl\u00e9my s uzav\u00edr\u00e1n\u00edm smluv, zakr\u00fdv\u00e1 nesrovnalosti v \u00fahrad\u00e1ch a doch\u00e1z\u00ed p\u0159i n\u00ed k z\u00e1niku kontroln\u00edch syst\u00e9m\u016f.<\/p>\n <\/p>\n
Jistota pat\u0159i\u010dn\u00e9ho o\u0161et\u0159en\u00ed i v p\u0159\u00edpad\u011b,\u017ee nemocn\u00fd nen\u00ed schopen nic zaplatit<\/strong>, je v \u010dele v\u0161ech priorit na\u0161ich ob\u010dan\u016f<\/strong>, ale byla a dosud je zpochyb\u0148ov\u00e1na tvrzen\u00edm, \u017ee \u00dastava \u010cR nic konkr\u00e9tn\u00edho nezaru\u010duje, \u017ee rozsah a kvalitu p\u00e9\u010de hrazen\u00e9 z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed m\u016f\u017eeme oby\u010dejn\u00fdm z\u00e1konem libovoln\u011b omezit. To nep\u0159ijateln\u011b zpochyb\u0148uje \u00fastavn\u00ed garance. Je t\u0159eba pouk\u00e1zat na Pakt o hospod\u00e1\u0159sk\u00fdch, soci\u00e1ln\u00edch a kulturn\u00edch pr\u00e1vech<\/strong>, platn\u00fd vy\u0161\u0161\u00ed mezin\u00e1rodn\u00ed z\u00e1kon, kter\u00fd ur\u010duje, \u017ee garantovan\u00e1 zdravotn\u00ed p\u00e9\u010de mus\u00ed b\u00fdt pat\u0159i\u010dn\u00e1<\/strong>. Pat\u0159i\u010dn\u00e1 p\u00e9\u010de je pojem, jeho\u017e obsah z\u00e1vis\u00ed na vysp\u011blosti st\u00e1tu a historick\u00fdch souvislostech, s p\u0159ihl\u00e9dnut\u00edm k priorit\u00e1m obyvatelstva. Nap\u0159\u00edklad v \u010cesk\u00e9 republice nem\u016f\u017ee b\u00fdt za pat\u0159i\u010dnou p\u00e9\u010di pova\u017eov\u00e1no n\u011bco m\u00e9n\u011b dobr\u00e9ho a \u00fapln\u00e9ho, ne\u017e v Rakousku nebo N\u011bmecku.<\/strong><\/p>\n\u00a0<\/strong><\/p>\nP\u0159\u00edjmy ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed<\/strong><\/span><\/h4>\n <\/p>\n
Ro\u010dn\u00ed n\u00e1klady na hospod\u00e1rn\u011b obstar\u00e1vanou pat\u0159i\u010dnou zdravotn\u00ed p\u00e9\u010di o v\u0161echny ob\u010dany, nav\u00fd\u0161en\u00e9 o provozn\u00ed n\u00e1klady poji\u0161\u0165ovny, p\u0159edstavuj\u00ed finan\u010dn\u00ed objem, kter\u00fd mus\u00ed ve form\u011b pojistn\u00e9ho, stanoven\u00e9ho z\u00e1konem, ve\u0159ejn\u00e1 poji\u0161\u0165ovna b\u011bhem roku dostat od ob\u010dan\u016f nebo st\u00e1tu.<\/strong><\/p>\n <\/p>\n
P\u0159i zav\u00e1d\u011bn\u00ed ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed v roce 1992 se nev\u011bd\u011blo, jak kvantifikovat\u00a0 pojistn\u00e9 placen\u00e9 za jednotliv\u00e9 ob\u010dany. Bylo navr\u017eeno 13.5 % z hrub\u00e9ho p\u0159\u00edjmu u vyd\u011bl\u00e1vaj\u00edc\u00edch, z toho 4.5 % zam\u011bstnanec a 9 % zam\u011bstnavatel. Za ob\u010dany bez p\u0159\u00edjmu m\u011bj platit st\u00e1t tolik, aby byla bilance ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed vyrovnan\u00e1.<\/strong> Velmi brzo vznikly pot\u00ed\u017ee vlivem \u0161patn\u011b veden\u00fdch poji\u0161\u0165oven a neschopnosti st\u00e1tn\u00ed spr\u00e1vy a politik\u016f adekv\u00e1tn\u011b reagovat. Men\u0161\u00ed poji\u0161\u0165ovny s bohat\u0161\u00edmi a zdrav\u011bj\u0161\u00edmi poji\u0161t\u011bnci od za\u010d\u00e1tku hromadily p\u0159ebytky a spekulovaly na budouc\u00ed privatizaci. N\u00e1vrhy racion\u00e1ln\u00edch \u0159e\u0161en\u00ed ze strany Svazu pacient\u016f \u010cR byly ignorov\u00e1ny, stejn\u011b jako po\u017eadavek sjednocen\u00ed poji\u0161\u0165oven pod jeden spole\u010dn\u00fd z\u00e1kon.<\/p>\n <\/p>\n
Positivn\u00ed vliv r\u016fstu pr\u016fm\u011brn\u00e9 mzdy na p\u0159\u00edjmy poji\u0161\u0165oven byl tlumen t\u00edm, \u017ee p\u0159ib\u00fdvalo\u00a0 osob pracuj\u00edc\u00edch v re\u017eimu OSV\u010c<\/strong>, kter\u00e9 z\u00e1kon bez \u0159\u00e1dn\u00e9ho d\u016fvodu zv\u00fdhod\u0148uje tak, \u017ee plat\u00ed v pr\u016fm\u011bru m\u00e9n\u011b ne\u017e polovi\u010dn\u00ed pojistn\u00e9 ve srovn\u00e1n\u00ed s pr\u016fm\u011brem u zam\u011bstnanc\u016f. Dal\u0161\u00ed \u00fabytek zp\u016fsobilo zaveden\u00ed strop\u016f<\/strong> br\u00e1n\u00edc\u00edch tomu, aby rostouc\u00ed po\u010det p\u0159\u00edjemc\u016f vysok\u00fdch plat\u016f, nav\u00edc nezd\u016fvodniteln\u00fdch osobn\u00ed produktivitou pr\u00e1ce, nemusel z toho, co nepr\u00e1vem dost\u00e1v\u00e1, platit ani t\u011bch 13.5 %. Zdokonalila se tak\u00e9 technika \u201eoptimalizace\u201c p\u0159izn\u00e1n\u00ed dan\u00ed<\/strong>, kter\u00e1 v mnoha p\u0159\u00edpadech <\/strong>velmi sn\u00ed\u017eila i z\u00e1klad pro v\u00fdpo\u010det zdravotn\u00edho pojistn\u00e9ho.<\/strong><\/p>\n <\/p>\n
Jen samo zv\u00fd\u0161en\u00ed DPH odv\u00e1d\u011blo ze zdravotnictv\u00ed a to jen za l\u00e9ky a zdravotnick\u00e9 pot\u0159eby <\/strong>asi 3.8 % ro\u010dn\u00edho obratu cel\u00e9ho zdravotnictv\u00ed, to je 11 miliard K\u010d<\/strong>. Neust\u00e1le rostl po\u010det ob\u010dan\u016f nevykazuj\u00edch \u017e\u00e1dn\u00e9 p\u0159\u00edjmy a po\u010det vyd\u011bl\u00e1vaj\u00edc\u00edch ob\u010dan\u016f klesl z 50 % na zhruba 40 %<\/strong>. Posledn\u00ed r\u00e1nu syst\u00e9mu ve\u0159ejn\u00e9ho zdravotnictv\u00ed<\/strong>, kter\u00e9 v\u011bt\u0161inou nakupuje za eura, zasadila \u010cNB znehodnocen\u00edm kurzu koruny<\/strong>. Ro\u010dn\u011b to p\u0159edstavuje, nap\u0159\u00edklad v roce 2015, 10.7 miliard K\u010d. Odhaduje se, \u017ee v\u00fdpadek na p\u0159\u00edjmov\u00e9 stran\u011b, zp\u016fsoben\u00fd t\u011bmito zm\u011bnami b\u011bhem posledn\u00edch 16 let, je asi 28 miliard K\u010d ro\u010dn\u011b. <\/strong><\/p>\n <\/p>\n
M\u00edsto kompenzace t\u011bchto ztr\u00e1t \u00fapravou pojistn\u00e9ho placen\u00e9ho st\u00e1tem byla<\/strong> dlouhodob\u011b jak\u00e1koliv jeho valorizace\u00a0 zastavena.<\/strong> Opakovaly se se pokusy, vyb\u00edrat r\u016fznou spolu\u00fa\u010dast\u00ed pacient\u016f chyb\u011bj\u00edc\u00ed pen\u00edze p\u0159\u00edmo od nemocn\u00fdch, tedy bez \u00dastavou \u010cR garantovan\u00e9 solidarity. Katastrof\u00e1ln\u00ed rozm\u011br to m\u00e1 ve stomatologii.<\/strong> Je\u0161t\u011b asoci\u00e1ln\u011bj\u0161\u00ed jsou n\u00e1vrhy, aby se z hrazen\u00ed ve\u0159ejnou poji\u0161\u0165ovnou vy\u0159adila \u010d\u00e1st \u00fapln\u00e9 p\u00e9\u010de a zavedlo se pro ni nesolid\u00e1rn\u00ed komer\u010dn\u00ed p\u0159ipoji\u0161t\u011bn\u00ed.<\/strong> V tomto p\u0159\u00edpad\u011b by za tuto \u010d\u00e1st p\u00e9\u010de ob\u010dan\u00e9 zaplatili je\u0161t\u011b nav\u00edc zisk poji\u0161\u0165oven a p\u0159ir\u00e1\u017eku za riziko podnik\u00e1n\u00ed, velmi nemocn\u00ed a chud\u00ed by z\u016fstali nepoji\u0161t\u011bni.<\/p>\n <\/p>\n
Ti, kdo volaj\u00ed po optimalizaci hospoda\u0159en\u00ed ve\u0159ejn\u00e9ho zdravotnictv\u00ed, by m\u011bli p\u0159edev\u0161\u00edm p\u0159ipravit sjednocen\u00ed v\u0161ech poji\u0161\u0165oven.<\/strong><\/span><\/h4>\n<\/h5>\nVe ve\u0159ejn\u00e9m zdravotnictv\u00ed se nepl\u00fdtv\u00e1, dost\u00e1v\u00e1 jen 75 % p\u0159\u00edjm\u016f, kter\u00e9 mu n\u00e1le\u017e\u00ed<\/strong><\/h5>\n\u00a0<\/strong><\/p>\nKvalitn\u00ed p\u00e9\u010de produkovan\u00e1 na\u0161\u00edm ve\u0159ejn\u00fdm zdravotnictv\u00edm se jev\u00ed ve srovn\u00e1n\u00ed se zahrani\u010d\u00edm jako levn\u00e1. <\/strong>Dost\u00e1v\u00e1 jako z\u00e1klad sv\u00fdch fond\u016f 13.5 % z hrub\u00fdch p\u0159\u00edjm\u016f vek\u00e9 v\u011bt\u0161iny ob\u010dan\u016f, a to by dob\u0159e sta\u010dilo, kdyby tyto p\u0159\u00edjmy p\u0159epo\u010dten\u00e9 na eura<\/strong> nebyly v pr\u016fm\u011bru jen 53 % p\u0159\u00edjm\u016f pr\u016fm\u011brn\u00e9ho Evropana a na \u00farovni jedn\u00e9 t\u0159etiny p\u0159\u00edjm\u016f Raku\u0161an\u016f a N\u011bmc\u016f<\/strong>. Tyto pom\u011bry ov\u0161em vych\u00e1zej\u00ed p\u0159i kurzu dr\u017een\u00e9m \u010cNB proti z\u00e1jm\u016fm \u010cR na 27 K\u010d za euro. P\u0159i kurzu stejn\u00e9 kupn\u00ed s\u00edly 17 K\u010d za euro by to bylo 84.2 % p\u0159\u00edjm\u016f pr\u016fm\u011brn\u00e9ho Evropana a asi 53% p\u0159\u00edjm\u016f \u00a0N\u011bmce nebo Raku\u0161ana.<\/strong> Asi tak je na tom ob\u010dan \u010cR, pokud sv\u00e9 p\u0159\u00edjmy uplat\u0148uje jen doma.<\/p>\n\u00a0<\/strong><\/p>\nI tato dom\u00e1c\u00ed kupn\u00ed s\u00edla p\u0159\u00edjm\u016f ob\u010dan\u016f \u010cR (asi 53 % kupn\u00ed s\u00edly p\u0159\u00edjm\u016f N\u011bmc\u016f nebo Raku\u0161an\u016f) je n\u00e1padn\u011b mal\u00e1. Hledejme tedy d\u00e1le. Hrub\u00fd dom\u00e1c\u00ed produkt vzta\u017een\u00fd na jednoho obyvatele je v \u010cR jen asi 70 % toho, \u010deho dosahuj\u00ed sousedn\u00ed z\u00e1padn\u00ed st\u00e1ty.<\/strong> Je to n\u00e1sledek p\u016fsoben\u00ed neschopn\u00fdch nebo v\u0161ehoschopn\u00fdch vl\u00e1d a mus\u00edme s t\u00edm po\u010d\u00edtat. Zb\u00fdv\u00e1 n\u00e1m ale vysv\u011btlit je\u0161t\u011b rozd\u00edl 17 % mezi 53 % a 70 %<\/strong>. Museli bychom zv\u00fd\u0161it p\u0159\u00edjmy pr\u016fm\u011brn\u00e9ho ob\u010dana o 32 %, aby stouply z 53 % na 70 % rakousk\u00fdch p\u0159\u00edjm\u016f.<\/strong> T\u011bch 32 % je ta slo\u017eka produktivit\u011b odpov\u00eddaj\u00edc\u00edch p\u0159\u00edjm\u016f ob\u010dan\u016f \u010cR, kter\u00e1 prost\u011b nen\u00ed vypl\u00e1cena a z\u016fst\u00e1v\u00e1 zam\u011bstnavatel\u016fm jako bezd\u016fvodn\u00fd zisk. <\/strong>Jak k tomu do\u0161lo?<\/p>\n\u00a0<\/strong><\/p>\nTento stav je d\u016fsledkem \u0161patn\u011b proveden\u00e9 transformace a je vinou na\u0161ich vl\u00e1d, \u017ee tato chyba nebyla ani konstatov\u00e1na, nato\u017e napravena. Do\u0161lo k tomu tak, \u017ee v dob\u011b, kdy skoro v\u0161echno bylo st\u00e1tn\u00ed, podstatnou sou\u010d\u00e1st\u00ed odm\u011bn za pr\u00e1ci byly benefity,<\/strong> jako dotovan\u00e1 ve\u0159ejn\u00e1 doprava, voda, energie, bydlen\u00ed, potraviny, zdravotnictv\u00ed a rekreace, kultura, po\u0161ta, neplatily se poplatky ani \u0161koln\u00e9 atd. St\u00e1t to platil za n\u00e1s z v\u00fdt\u011b\u017eku za produkci st\u00e1tn\u00edch podnik\u016f, ale kdy\u017e do\u0161lo k bezhlav\u00e9 privatizaci a ke zru\u0161en\u00ed dotac\u00ed, nebyly z nich plynouc\u00ed benefity zahrnuty do mezd a plat\u016f. Nejen nov\u00ed majitel\u00e9, ale i st\u00e1t, to nechali b\u00fdt.<\/strong><\/p>\n\u00a0<\/strong><\/p>\nN\u00e1sledky t\u00e9to chyby jsou obrovsk\u00e9. Nevyplacen\u00e9 \u010d\u00e1sti mezd odch\u00e1zej\u00ed ve form\u011b dividend jako bezd\u016fvodn\u00fd zisk na konta zahrani\u010dn\u00edch majitel\u016f <\/strong>hloup\u011b zprivatizovan\u00fdch podnik\u016f.<\/p>\n\u00a0<\/strong><\/p>\nOsudn\u00e9 je, \u017ee p\u0159\u00edjmy za pr\u00e1ci ob\u010dan\u016f jsou zdrojem odvod\u016f pro financov\u00e1n\u00ed zdravotnictv\u00ed, d\u016fchod\u016f a soci\u00e1ln\u00ed p\u00e9\u010de, jako\u017e i zdrojem obecn\u00fdch dan\u00ed.<\/strong> Je snadn\u00e9 pochopit, co by znamenal pro zdravotnictv\u00ed o 32 % v\u011bt\u0161\u00ed v\u00fdb\u011br pojistn\u00e9ho (asi 76 miliard K\u010d)<\/strong>, o ostatn\u00edch soci\u00e1ln\u00edch syst\u00e9mech nemluv\u011b.<\/p>\nI potom by ve\u0159ejn\u00e9 zdravotnictv\u00ed bylo dost levn\u00e9, jen 8.9 % HDP<\/strong>.<\/p>\n <\/p>\n
Prosadit vy\u0161\u0161\u00ed cenu pr\u00e1ce je \u00fakol pro ministra financ\u00ed a vl\u00e1du.<\/strong> Teprve a\u017e se jim to poda\u0159\u00ed, bude mo\u017en\u00e9 uva\u017eovat, zda se ve ve\u0159ejn\u00e9m zdravotnictv\u00ed nepl\u00fdtv\u00e1. Zat\u00edm nen\u00ed z \u010deho pl\u00fdtvat.<\/p>\n\u00a0<\/strong><\/p>\nJak dos\u00e1hnout \u00fapravy mezd a plat\u016f je p\u0159edm\u011btem jin\u00e9ho rozboru<\/strong> a uk\u00e1\u017ee se p\u0159itom, \u017ee jsou pozice, kde nen\u00ed t\u0159eba nic p\u0159id\u00e1vat, sami si nabrali, co cht\u011bli, jako advok\u00e1ti, bankste\u0159i, mana\u017ee\u0159i a kamar\u00e1di politik\u016f. Tam je pot\u0159eba sp\u00ed\u0161e ubrat, aby rozd\u00edl mezi medi\u00e1nem mezd a pr\u016fm\u011brnou mzdou nebyl tak dramatick\u00fd ( 22 %). Zv\u00fd\u0161en\u00ed se mus\u00ed t\u00fdkat p\u0159edev\u0161\u00edm n\u00edzk\u00fdch a st\u0159edn\u00edch mzdov\u00fdch hladin.<\/p>\n <\/p>\n
Jak udr\u017eet l\u00e9ka\u0159e a zdravotn\u00ed sestry v republice<\/strong><\/span><\/h4>\n\u00a0<\/strong><\/p>\nV roce 1995 jsem sly\u0161el od \u0159eck\u00e9ho profesora, \u017ee nen\u00ed t\u0159eba litovat n\u00e1klad\u016f ztracen\u00fdch t\u00edm, \u017ee n\u011bkte\u0159\u00ed na n\u00e1klady st\u00e1tu vystudovan\u00ed l\u00e9ka\u0159i odch\u00e1zej\u00ed do ciziny. \u0158ekl, \u017ee v\u011bt\u0161inou se do \u0158ecka vr\u00e1t\u00ed a p\u0159inesou cenn\u00e9 zku\u0161enosti. Moc mne nep\u0159esv\u011bd\u010dil, ale jen m\u00e1lo l\u00e9ka\u0159\u016f a sester tehdy od n\u00e1s odch\u00e1zelo. Postupem \u010dasu z\u00e1padn\u00ed st\u00e1ty, v\u011bdomy si kvality na\u0161ich absolvent\u016f, zlep\u0161ovaly podm\u00ednky pro jejich p\u0159ijet\u00ed a naopak obt\u00ed\u017enost z\u00edsk\u00e1v\u00e1n\u00ed samostatnosti a dlouh\u00e1 doba k tomu pot\u0159ebn\u00e1 v \u010cR p\u0159i nejmen\u0161\u00edm p\u0159etrv\u00e1vala. Kdy\u017e padla v\u0161echna omezen\u00ed z hlediska p\u0159edpis\u016f EU, nebylo ji\u017e, krom\u011b nechuti pracovat v cizin\u011b, nic, co by vyva\u017eovalo nesrovnateln\u011b lep\u0161\u00ed odm\u011b\u0148ov\u00e1n\u00ed za z\u00e1padn\u00edmi hranicemi.<\/strong><\/p>\n\u00a0<\/strong><\/p>\nNa sklonku dvades\u00e1t\u00fdch let byly platy ve zdravotnictv\u00ed tak \u0161patn\u00e9, \u017ee zaost\u00e1valy i za platy v oborech mnohem m\u00e9n\u011b n\u00e1ro\u010dn\u00fdch na p\u0159\u00edpravu na povol\u00e1n\u00ed, ale m\u00e9n\u011b regulovan\u00fdch. Po n\u011bkolika \u00faprav\u00e1ch b\u011bhem patn\u00e1cti let dos\u00e1hl pom\u011br plat\u016f ve zdravotnictv\u00ed k pr\u016fm\u011brn\u00e9 mzd\u011b hodnot bl\u00ed\u017e\u00edc\u00edch se obdobn\u00fdm p\u0159\u00edpad\u016fm v z\u00e1padn\u00edch st\u00e1tech. \u0160lo v\u0161ak o pom\u011br k pr\u016fm\u011brn\u00e9 mzd\u011b s kupn\u00ed silou m\u00e9n\u011b ne\u017e polovi\u010dn\u00ed ve srovn\u00e1n\u00ed s Rakouskem,<\/strong> a pro cizinu tak\u00e9 sv\u011bd\u010dila vyhl\u00eddka na d\u0159\u00edv\u011bj\u0161\u00ed dosa\u017een\u00ed pln\u00e9ho platu a men\u0161\u00ed zat\u00ed\u017een\u00ed p\u0159es\u010dasy. Proto odch\u00e1z\u00ed st\u00e1le hodn\u011b a zvl\u00e1\u0161t\u011b mlad\u00fdch l\u00e9ka\u0159\u016f do ciziny a hodn\u011b zdravotn\u00edch sester d\u00e1v\u00e1 p\u0159ednost uplatn\u011bn\u00ed v m\u00e9n\u011b n\u00e1ro\u010dn\u00fdch povol\u00e1n\u00edch. <\/strong>Je ohro\u017een chod nemocnic a dostupnost z\u00e1kladn\u00ed l\u00e9ka\u0159sk\u00e9 p\u00e9\u010de zejm\u00e9na v okrajov\u00fdch okresech republiky.<\/p>\n\u00a0<\/strong><\/p>\nVl\u00e1da<\/strong> by m\u011bla hned umo\u017enit podstatn\u00e9 zv\u00fd\u0161en\u00ed plat\u016f ve zdravotnictv\u00ed velk\u00fdm zv\u00fd\u0161en\u00edm pojistn\u00e9ho placen\u00e9ho st\u00e1tem<\/strong>, proto\u017ee je jej\u00ed vinou, \u017ee dovoluje u n\u011bkter\u00fdch profes\u00ed a u vybran\u00fdch pracovn\u00edk\u016f ve sf\u00e9\u0159e st\u00e1tn\u00edho vlivu mimo\u0159\u00e1dn\u00e9 p\u0159\u00edjmy a neu\u010dinila skoro nic pro systematick\u00e9 zv\u00fd\u0161en\u00ed ceny b\u011b\u017en\u00e9 pr\u00e1ce. N\u00e1sledovat mus\u00ed jako optim\u00e1ln\u00ed \u0159e\u0161en\u00ed v\u0161eobecn\u00e9 zv\u00fd\u0161en\u00ed ceny pr\u00e1ce o n\u011bkolik des\u00edtek procent<\/strong>. To vy\u0159e\u0161\u00ed v\u00edce probl\u00e9m\u016f, ne\u017e jen zdravotnictv\u00ed, a je to relativn\u011b snadno dosa\u017eiteln\u00e9, spot\u0159ebovalo by to v\u011bt\u0161\u00ed \u010d\u00e1st bezd\u016fvodn\u00fdch zisk\u016f a trochu nahradilo nedostate\u010dn\u00e9 zdan\u011bn\u00ed v\u00fdnos\u016f z podnik\u00e1n\u00ed. To ale ji\u017e nen\u00ed jen zdravotnick\u00fd, ale v\u0161eobecn\u00fd n\u00e1rodohospod\u00e1\u0159sk\u00fd probl\u00e9m.<\/strong><\/p>\n <\/p>\n
<\/p>\n
Praha 12.4.2016<\/p>\n
Gr\u00e9mium Svazu pacient\u016f \u010cR<\/p>\n
Ing. Josef Mr\u00e1zek, CSc. viceprezident<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Kl\u00ed\u010d k n\u00e1prav\u011b financov\u00e1n\u00ed ve\u0159ejn\u00e9ho zdravotnictv\u00ed Na co mus\u00ed m\u00edt ve\u0159ejn\u00e9 zdravotn\u00ed poji\u0161t\u011bn\u00ed pen\u00edze \u00dastava \u010cR ukl\u00e1d\u00e1 st\u00e1tu, aby zaji\u0161\u0165oval dostupnost zdravotn\u00ed p\u00e9\u010de pro ka\u017ed\u00e9ho ob\u010dana. Jde o rovn\u00fd p\u0159\u00edstup k pat\u0159i\u010dn\u00e9, to jest \u00fapln\u00e9 a kvalitn\u00ed p\u00e9\u010di,\u00a0 jak to bl\u00ed\u017ee ur\u010duj\u00ed dal\u0161\u00ed z\u00e1kony vy\u0161\u0161\u00ed pr\u00e1vn\u00ed s\u00edly. St\u00e1t odpov\u00edd\u00e1 za fungov\u00e1n\u00ed ve\u0159ejn\u00e9ho […]<\/p>\n","protected":false},"author":1,"featured_media":285,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14],"tags":[],"_links":{"self":[{"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/posts\/817"}],"collection":[{"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=817"}],"version-history":[{"count":6,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/posts\/817\/revisions"}],"predecessor-version":[{"id":857,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/posts\/817\/revisions\/857"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/media\/285"}],"wp:attachment":[{"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=817"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=817"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=817"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"insurance-911819__180\"](\"https:\/\/www.pacienti.cz\/wp-content\/uploads\/2015\/08\/insurance-911819__180.png\")
<\/a>k n\u00e1prav\u011b financov\u00e1n\u00ed ve\u0159ejn\u00e9ho zdravotnictv\u00ed<\/span><\/strong><\/h1>\n<\/p>\n
\u00dastava \u010cR ukl\u00e1d\u00e1 st\u00e1tu, aby zaji\u0161\u0165oval dostupnost zdravotn\u00ed p\u00e9\u010de pro ka\u017ed\u00e9ho ob\u010dana. Jde o rovn\u00fd p\u0159\u00edstup k pat\u0159i\u010dn\u00e9, to jest \u00fapln\u00e9 a kvalitn\u00ed p\u00e9\u010di,\u00a0 jak to bl\u00ed\u017ee ur\u010duj\u00ed dal\u0161\u00ed z\u00e1kony vy\u0161\u0161\u00ed pr\u00e1vn\u00ed s\u00edly. St\u00e1t odpov\u00edd\u00e1 za fungov\u00e1n\u00ed ve\u0159ejn\u00e9ho zdravotnictv\u00ed<\/strong>, schopn\u00e9ho poskytovat garantovanou p\u00e9\u010di kvalitn\u011b a hospod\u00e1rn\u011b.<\/p>\n \u00dastava \u010cR tak\u00e9 stanov\u00ed, \u017ee tato p\u00e9\u010de se p\u0159\u00edmo neplat\u00ed, hrad\u00ed se solid\u00e1rn\u011b z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed, co\u017e pro st\u00e1t znamen\u00e1 z\u0159\u00eddit a m\u00edt pod kontrolou ve\u0159ejnou zdravotn\u00ed poji\u0161\u0165ovnu<\/strong>.<\/p>\n <\/p>\n Na soukrom\u00fd subjekt nelze odpov\u011bdnost za pln\u011bn\u00ed \u00fastavn\u00ed povinnosti p\u0159en\u00e9st. Z\u00e1kon sv\u011b\u0159uje ve\u0159ejn\u00e9 zdravotn\u00ed poji\u0161\u0165ovn\u011b\u00a0 hospoda\u0159en\u00ed s ve\u0159ejn\u00fdmi prost\u0159edky<\/strong>, kter\u00e9 mus\u00ed b\u00fdt pou\u017e\u00edv\u00e1ny hospod\u00e1rn\u011b. To se\u00a0 nejl\u00e9pe poda\u0159\u00ed, kdy\u017e je<\/strong> poji\u0161\u0165ovna jen jedna<\/strong> a p\u0159esn\u011b pln\u00ed z\u00e1kon. Pluralita poji\u0161\u0165oven zv\u011bt\u0161uje provozn\u00ed n\u00e1klady, kter\u00e9 p\u0159i jedn\u00e9 poji\u0161\u0165ovn\u011b mohou b\u00fdt pod 3% obratu, v zem\u00edch s rozvinutou pluralitou je to i v\u00edce ne\u017e 6%. V \u010cR by to bylo asi 10 miliard K\u010d za rok, stejn\u011b jako zv\u00fd\u0161en\u00ed st\u00e1tem placen\u00e9ho pojistn\u00e9ho o 210 K\u010d m\u011bs\u00ed\u010dn\u011b. Pluralita tak\u00e9 zp\u016fsobuje probl\u00e9my s uzav\u00edr\u00e1n\u00edm smluv, zakr\u00fdv\u00e1 nesrovnalosti v \u00fahrad\u00e1ch a doch\u00e1z\u00ed p\u0159i n\u00ed k z\u00e1niku kontroln\u00edch syst\u00e9m\u016f.<\/p>\n <\/p>\n Jistota pat\u0159i\u010dn\u00e9ho o\u0161et\u0159en\u00ed i v p\u0159\u00edpad\u011b,\u017ee nemocn\u00fd nen\u00ed schopen nic zaplatit<\/strong>, je v \u010dele v\u0161ech priorit na\u0161ich ob\u010dan\u016f<\/strong>, ale byla a dosud je zpochyb\u0148ov\u00e1na tvrzen\u00edm, \u017ee \u00dastava \u010cR nic konkr\u00e9tn\u00edho nezaru\u010duje, \u017ee rozsah a kvalitu p\u00e9\u010de hrazen\u00e9 z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed m\u016f\u017eeme oby\u010dejn\u00fdm z\u00e1konem libovoln\u011b omezit. To nep\u0159ijateln\u011b zpochyb\u0148uje \u00fastavn\u00ed garance. Je t\u0159eba pouk\u00e1zat na Pakt o hospod\u00e1\u0159sk\u00fdch, soci\u00e1ln\u00edch a kulturn\u00edch pr\u00e1vech<\/strong>, platn\u00fd vy\u0161\u0161\u00ed mezin\u00e1rodn\u00ed z\u00e1kon, kter\u00fd ur\u010duje, \u017ee garantovan\u00e1 zdravotn\u00ed p\u00e9\u010de mus\u00ed b\u00fdt pat\u0159i\u010dn\u00e1<\/strong>. Pat\u0159i\u010dn\u00e1 p\u00e9\u010de je pojem, jeho\u017e obsah z\u00e1vis\u00ed na vysp\u011blosti st\u00e1tu a historick\u00fdch souvislostech, s p\u0159ihl\u00e9dnut\u00edm k priorit\u00e1m obyvatelstva. Nap\u0159\u00edklad v \u010cesk\u00e9 republice nem\u016f\u017ee b\u00fdt za pat\u0159i\u010dnou p\u00e9\u010di pova\u017eov\u00e1no n\u011bco m\u00e9n\u011b dobr\u00e9ho a \u00fapln\u00e9ho, ne\u017e v Rakousku nebo N\u011bmecku.<\/strong><\/p>\n \u00a0<\/strong><\/p>\n <\/p>\n Ro\u010dn\u00ed n\u00e1klady na hospod\u00e1rn\u011b obstar\u00e1vanou pat\u0159i\u010dnou zdravotn\u00ed p\u00e9\u010di o v\u0161echny ob\u010dany, nav\u00fd\u0161en\u00e9 o provozn\u00ed n\u00e1klady poji\u0161\u0165ovny, p\u0159edstavuj\u00ed finan\u010dn\u00ed objem, kter\u00fd mus\u00ed ve form\u011b pojistn\u00e9ho, stanoven\u00e9ho z\u00e1konem, ve\u0159ejn\u00e1 poji\u0161\u0165ovna b\u011bhem roku dostat od ob\u010dan\u016f nebo st\u00e1tu.<\/strong><\/p>\n <\/p>\n P\u0159i zav\u00e1d\u011bn\u00ed ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed v roce 1992 se nev\u011bd\u011blo, jak kvantifikovat\u00a0 pojistn\u00e9 placen\u00e9 za jednotliv\u00e9 ob\u010dany. Bylo navr\u017eeno 13.5 % z hrub\u00e9ho p\u0159\u00edjmu u vyd\u011bl\u00e1vaj\u00edc\u00edch, z toho 4.5 % zam\u011bstnanec a 9 % zam\u011bstnavatel. Za ob\u010dany bez p\u0159\u00edjmu m\u011bj platit st\u00e1t tolik, aby byla bilance ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed vyrovnan\u00e1.<\/strong> Velmi brzo vznikly pot\u00ed\u017ee vlivem \u0161patn\u011b veden\u00fdch poji\u0161\u0165oven a neschopnosti st\u00e1tn\u00ed spr\u00e1vy a politik\u016f adekv\u00e1tn\u011b reagovat. Men\u0161\u00ed poji\u0161\u0165ovny s bohat\u0161\u00edmi a zdrav\u011bj\u0161\u00edmi poji\u0161t\u011bnci od za\u010d\u00e1tku hromadily p\u0159ebytky a spekulovaly na budouc\u00ed privatizaci. N\u00e1vrhy racion\u00e1ln\u00edch \u0159e\u0161en\u00ed ze strany Svazu pacient\u016f \u010cR byly ignorov\u00e1ny, stejn\u011b jako po\u017eadavek sjednocen\u00ed poji\u0161\u0165oven pod jeden spole\u010dn\u00fd z\u00e1kon.<\/p>\n <\/p>\n Positivn\u00ed vliv r\u016fstu pr\u016fm\u011brn\u00e9 mzdy na p\u0159\u00edjmy poji\u0161\u0165oven byl tlumen t\u00edm, \u017ee p\u0159ib\u00fdvalo\u00a0 osob pracuj\u00edc\u00edch v re\u017eimu OSV\u010c<\/strong>, kter\u00e9 z\u00e1kon bez \u0159\u00e1dn\u00e9ho d\u016fvodu zv\u00fdhod\u0148uje tak, \u017ee plat\u00ed v pr\u016fm\u011bru m\u00e9n\u011b ne\u017e polovi\u010dn\u00ed pojistn\u00e9 ve srovn\u00e1n\u00ed s pr\u016fm\u011brem u zam\u011bstnanc\u016f. Dal\u0161\u00ed \u00fabytek zp\u016fsobilo zaveden\u00ed strop\u016f<\/strong> br\u00e1n\u00edc\u00edch tomu, aby rostouc\u00ed po\u010det p\u0159\u00edjemc\u016f vysok\u00fdch plat\u016f, nav\u00edc nezd\u016fvodniteln\u00fdch osobn\u00ed produktivitou pr\u00e1ce, nemusel z toho, co nepr\u00e1vem dost\u00e1v\u00e1, platit ani t\u011bch 13.5 %. Zdokonalila se tak\u00e9 technika \u201eoptimalizace\u201c p\u0159izn\u00e1n\u00ed dan\u00ed<\/strong>, kter\u00e1 v mnoha p\u0159\u00edpadech <\/strong>velmi sn\u00ed\u017eila i z\u00e1klad pro v\u00fdpo\u010det zdravotn\u00edho pojistn\u00e9ho.<\/strong><\/p>\n <\/p>\n Jen samo zv\u00fd\u0161en\u00ed DPH odv\u00e1d\u011blo ze zdravotnictv\u00ed a to jen za l\u00e9ky a zdravotnick\u00e9 pot\u0159eby <\/strong>asi 3.8 % ro\u010dn\u00edho obratu cel\u00e9ho zdravotnictv\u00ed, to je 11 miliard K\u010d<\/strong>. Neust\u00e1le rostl po\u010det ob\u010dan\u016f nevykazuj\u00edch \u017e\u00e1dn\u00e9 p\u0159\u00edjmy a po\u010det vyd\u011bl\u00e1vaj\u00edc\u00edch ob\u010dan\u016f klesl z 50 % na zhruba 40 %<\/strong>. Posledn\u00ed r\u00e1nu syst\u00e9mu ve\u0159ejn\u00e9ho zdravotnictv\u00ed<\/strong>, kter\u00e9 v\u011bt\u0161inou nakupuje za eura, zasadila \u010cNB znehodnocen\u00edm kurzu koruny<\/strong>. Ro\u010dn\u011b to p\u0159edstavuje, nap\u0159\u00edklad v roce 2015, 10.7 miliard K\u010d. Odhaduje se, \u017ee v\u00fdpadek na p\u0159\u00edjmov\u00e9 stran\u011b, zp\u016fsoben\u00fd t\u011bmito zm\u011bnami b\u011bhem posledn\u00edch 16 let, je asi 28 miliard K\u010d ro\u010dn\u011b. <\/strong><\/p>\n <\/p>\n M\u00edsto kompenzace t\u011bchto ztr\u00e1t \u00fapravou pojistn\u00e9ho placen\u00e9ho st\u00e1tem byla<\/strong> dlouhodob\u011b jak\u00e1koliv jeho valorizace\u00a0 zastavena.<\/strong> Opakovaly se se pokusy, vyb\u00edrat r\u016fznou spolu\u00fa\u010dast\u00ed pacient\u016f chyb\u011bj\u00edc\u00ed pen\u00edze p\u0159\u00edmo od nemocn\u00fdch, tedy bez \u00dastavou \u010cR garantovan\u00e9 solidarity. Katastrof\u00e1ln\u00ed rozm\u011br to m\u00e1 ve stomatologii.<\/strong> Je\u0161t\u011b asoci\u00e1ln\u011bj\u0161\u00ed jsou n\u00e1vrhy, aby se z hrazen\u00ed ve\u0159ejnou poji\u0161\u0165ovnou vy\u0159adila \u010d\u00e1st \u00fapln\u00e9 p\u00e9\u010de a zavedlo se pro ni nesolid\u00e1rn\u00ed komer\u010dn\u00ed p\u0159ipoji\u0161t\u011bn\u00ed.<\/strong> V tomto p\u0159\u00edpad\u011b by za tuto \u010d\u00e1st p\u00e9\u010de ob\u010dan\u00e9 zaplatili je\u0161t\u011b nav\u00edc zisk poji\u0161\u0165oven a p\u0159ir\u00e1\u017eku za riziko podnik\u00e1n\u00ed, velmi nemocn\u00ed a chud\u00ed by z\u016fstali nepoji\u0161t\u011bni.<\/p>\n <\/p>\n \u00a0<\/strong><\/p>\n Kvalitn\u00ed p\u00e9\u010de produkovan\u00e1 na\u0161\u00edm ve\u0159ejn\u00fdm zdravotnictv\u00edm se jev\u00ed ve srovn\u00e1n\u00ed se zahrani\u010d\u00edm jako levn\u00e1. <\/strong>Dost\u00e1v\u00e1 jako z\u00e1klad sv\u00fdch fond\u016f 13.5 % z hrub\u00fdch p\u0159\u00edjm\u016f vek\u00e9 v\u011bt\u0161iny ob\u010dan\u016f, a to by dob\u0159e sta\u010dilo, kdyby tyto p\u0159\u00edjmy p\u0159epo\u010dten\u00e9 na eura<\/strong> nebyly v pr\u016fm\u011bru jen 53 % p\u0159\u00edjm\u016f pr\u016fm\u011brn\u00e9ho Evropana a na \u00farovni jedn\u00e9 t\u0159etiny p\u0159\u00edjm\u016f Raku\u0161an\u016f a N\u011bmc\u016f<\/strong>. Tyto pom\u011bry ov\u0161em vych\u00e1zej\u00ed p\u0159i kurzu dr\u017een\u00e9m \u010cNB proti z\u00e1jm\u016fm \u010cR na 27 K\u010d za euro. P\u0159i kurzu stejn\u00e9 kupn\u00ed s\u00edly 17 K\u010d za euro by to bylo 84.2 % p\u0159\u00edjm\u016f pr\u016fm\u011brn\u00e9ho Evropana a asi 53% p\u0159\u00edjm\u016f \u00a0N\u011bmce nebo Raku\u0161ana.<\/strong> Asi tak je na tom ob\u010dan \u010cR, pokud sv\u00e9 p\u0159\u00edjmy uplat\u0148uje jen doma.<\/p>\n \u00a0<\/strong><\/p>\n I tato dom\u00e1c\u00ed kupn\u00ed s\u00edla p\u0159\u00edjm\u016f ob\u010dan\u016f \u010cR (asi 53 % kupn\u00ed s\u00edly p\u0159\u00edjm\u016f N\u011bmc\u016f nebo Raku\u0161an\u016f) je n\u00e1padn\u011b mal\u00e1. Hledejme tedy d\u00e1le. Hrub\u00fd dom\u00e1c\u00ed produkt vzta\u017een\u00fd na jednoho obyvatele je v \u010cR jen asi 70 % toho, \u010deho dosahuj\u00ed sousedn\u00ed z\u00e1padn\u00ed st\u00e1ty.<\/strong> Je to n\u00e1sledek p\u016fsoben\u00ed neschopn\u00fdch nebo v\u0161ehoschopn\u00fdch vl\u00e1d a mus\u00edme s t\u00edm po\u010d\u00edtat. Zb\u00fdv\u00e1 n\u00e1m ale vysv\u011btlit je\u0161t\u011b rozd\u00edl 17 % mezi 53 % a 70 %<\/strong>. Museli bychom zv\u00fd\u0161it p\u0159\u00edjmy pr\u016fm\u011brn\u00e9ho ob\u010dana o 32 %, aby stouply z 53 % na 70 % rakousk\u00fdch p\u0159\u00edjm\u016f.<\/strong> T\u011bch 32 % je ta slo\u017eka produktivit\u011b odpov\u00eddaj\u00edc\u00edch p\u0159\u00edjm\u016f ob\u010dan\u016f \u010cR, kter\u00e1 prost\u011b nen\u00ed vypl\u00e1cena a z\u016fst\u00e1v\u00e1 zam\u011bstnavatel\u016fm jako bezd\u016fvodn\u00fd zisk. <\/strong>Jak k tomu do\u0161lo?<\/p>\n \u00a0<\/strong><\/p>\n Tento stav je d\u016fsledkem \u0161patn\u011b proveden\u00e9 transformace a je vinou na\u0161ich vl\u00e1d, \u017ee tato chyba nebyla ani konstatov\u00e1na, nato\u017e napravena. Do\u0161lo k tomu tak, \u017ee v dob\u011b, kdy skoro v\u0161echno bylo st\u00e1tn\u00ed, podstatnou sou\u010d\u00e1st\u00ed odm\u011bn za pr\u00e1ci byly benefity,<\/strong> jako dotovan\u00e1 ve\u0159ejn\u00e1 doprava, voda, energie, bydlen\u00ed, potraviny, zdravotnictv\u00ed a rekreace, kultura, po\u0161ta, neplatily se poplatky ani \u0161koln\u00e9 atd. St\u00e1t to platil za n\u00e1s z v\u00fdt\u011b\u017eku za produkci st\u00e1tn\u00edch podnik\u016f, ale kdy\u017e do\u0161lo k bezhlav\u00e9 privatizaci a ke zru\u0161en\u00ed dotac\u00ed, nebyly z nich plynouc\u00ed benefity zahrnuty do mezd a plat\u016f. Nejen nov\u00ed majitel\u00e9, ale i st\u00e1t, to nechali b\u00fdt.<\/strong><\/p>\n \u00a0<\/strong><\/p>\n N\u00e1sledky t\u00e9to chyby jsou obrovsk\u00e9. Nevyplacen\u00e9 \u010d\u00e1sti mezd odch\u00e1zej\u00ed ve form\u011b dividend jako bezd\u016fvodn\u00fd zisk na konta zahrani\u010dn\u00edch majitel\u016f <\/strong>hloup\u011b zprivatizovan\u00fdch podnik\u016f.<\/p>\n \u00a0<\/strong><\/p>\n Osudn\u00e9 je, \u017ee p\u0159\u00edjmy za pr\u00e1ci ob\u010dan\u016f jsou zdrojem odvod\u016f pro financov\u00e1n\u00ed zdravotnictv\u00ed, d\u016fchod\u016f a soci\u00e1ln\u00ed p\u00e9\u010de, jako\u017e i zdrojem obecn\u00fdch dan\u00ed.<\/strong> Je snadn\u00e9 pochopit, co by znamenal pro zdravotnictv\u00ed o 32 % v\u011bt\u0161\u00ed v\u00fdb\u011br pojistn\u00e9ho (asi 76 miliard K\u010d)<\/strong>, o ostatn\u00edch soci\u00e1ln\u00edch syst\u00e9mech nemluv\u011b.<\/p>\n I potom by ve\u0159ejn\u00e9 zdravotnictv\u00ed bylo dost levn\u00e9, jen 8.9 % HDP<\/strong>.<\/p>\n <\/p>\n Prosadit vy\u0161\u0161\u00ed cenu pr\u00e1ce je \u00fakol pro ministra financ\u00ed a vl\u00e1du.<\/strong> Teprve a\u017e se jim to poda\u0159\u00ed, bude mo\u017en\u00e9 uva\u017eovat, zda se ve ve\u0159ejn\u00e9m zdravotnictv\u00ed nepl\u00fdtv\u00e1. Zat\u00edm nen\u00ed z \u010deho pl\u00fdtvat.<\/p>\n \u00a0<\/strong><\/p>\n Jak dos\u00e1hnout \u00fapravy mezd a plat\u016f je p\u0159edm\u011btem jin\u00e9ho rozboru<\/strong> a uk\u00e1\u017ee se p\u0159itom, \u017ee jsou pozice, kde nen\u00ed t\u0159eba nic p\u0159id\u00e1vat, sami si nabrali, co cht\u011bli, jako advok\u00e1ti, bankste\u0159i, mana\u017ee\u0159i a kamar\u00e1di politik\u016f. Tam je pot\u0159eba sp\u00ed\u0161e ubrat, aby rozd\u00edl mezi medi\u00e1nem mezd a pr\u016fm\u011brnou mzdou nebyl tak dramatick\u00fd ( 22 %). Zv\u00fd\u0161en\u00ed se mus\u00ed t\u00fdkat p\u0159edev\u0161\u00edm n\u00edzk\u00fdch a st\u0159edn\u00edch mzdov\u00fdch hladin.<\/p>\n <\/p>\n \u00a0<\/strong><\/p>\n V roce 1995 jsem sly\u0161el od \u0159eck\u00e9ho profesora, \u017ee nen\u00ed t\u0159eba litovat n\u00e1klad\u016f ztracen\u00fdch t\u00edm, \u017ee n\u011bkte\u0159\u00ed na n\u00e1klady st\u00e1tu vystudovan\u00ed l\u00e9ka\u0159i odch\u00e1zej\u00ed do ciziny. \u0158ekl, \u017ee v\u011bt\u0161inou se do \u0158ecka vr\u00e1t\u00ed a p\u0159inesou cenn\u00e9 zku\u0161enosti. Moc mne nep\u0159esv\u011bd\u010dil, ale jen m\u00e1lo l\u00e9ka\u0159\u016f a sester tehdy od n\u00e1s odch\u00e1zelo. Postupem \u010dasu z\u00e1padn\u00ed st\u00e1ty, v\u011bdomy si kvality na\u0161ich absolvent\u016f, zlep\u0161ovaly podm\u00ednky pro jejich p\u0159ijet\u00ed a naopak obt\u00ed\u017enost z\u00edsk\u00e1v\u00e1n\u00ed samostatnosti a dlouh\u00e1 doba k tomu pot\u0159ebn\u00e1 v \u010cR p\u0159i nejmen\u0161\u00edm p\u0159etrv\u00e1vala. Kdy\u017e padla v\u0161echna omezen\u00ed z hlediska p\u0159edpis\u016f EU, nebylo ji\u017e, krom\u011b nechuti pracovat v cizin\u011b, nic, co by vyva\u017eovalo nesrovnateln\u011b lep\u0161\u00ed odm\u011b\u0148ov\u00e1n\u00ed za z\u00e1padn\u00edmi hranicemi.<\/strong><\/p>\n \u00a0<\/strong><\/p>\n Na sklonku dvades\u00e1t\u00fdch let byly platy ve zdravotnictv\u00ed tak \u0161patn\u00e9, \u017ee zaost\u00e1valy i za platy v oborech mnohem m\u00e9n\u011b n\u00e1ro\u010dn\u00fdch na p\u0159\u00edpravu na povol\u00e1n\u00ed, ale m\u00e9n\u011b regulovan\u00fdch. Po n\u011bkolika \u00faprav\u00e1ch b\u011bhem patn\u00e1cti let dos\u00e1hl pom\u011br plat\u016f ve zdravotnictv\u00ed k pr\u016fm\u011brn\u00e9 mzd\u011b hodnot bl\u00ed\u017e\u00edc\u00edch se obdobn\u00fdm p\u0159\u00edpad\u016fm v z\u00e1padn\u00edch st\u00e1tech. \u0160lo v\u0161ak o pom\u011br k pr\u016fm\u011brn\u00e9 mzd\u011b s kupn\u00ed silou m\u00e9n\u011b ne\u017e polovi\u010dn\u00ed ve srovn\u00e1n\u00ed s Rakouskem,<\/strong> a pro cizinu tak\u00e9 sv\u011bd\u010dila vyhl\u00eddka na d\u0159\u00edv\u011bj\u0161\u00ed dosa\u017een\u00ed pln\u00e9ho platu a men\u0161\u00ed zat\u00ed\u017een\u00ed p\u0159es\u010dasy. Proto odch\u00e1z\u00ed st\u00e1le hodn\u011b a zvl\u00e1\u0161t\u011b mlad\u00fdch l\u00e9ka\u0159\u016f do ciziny a hodn\u011b zdravotn\u00edch sester d\u00e1v\u00e1 p\u0159ednost uplatn\u011bn\u00ed v m\u00e9n\u011b n\u00e1ro\u010dn\u00fdch povol\u00e1n\u00edch. <\/strong>Je ohro\u017een chod nemocnic a dostupnost z\u00e1kladn\u00ed l\u00e9ka\u0159sk\u00e9 p\u00e9\u010de zejm\u00e9na v okrajov\u00fdch okresech republiky.<\/p>\n \u00a0<\/strong><\/p>\n Vl\u00e1da<\/strong> by m\u011bla hned umo\u017enit podstatn\u00e9 zv\u00fd\u0161en\u00ed plat\u016f ve zdravotnictv\u00ed velk\u00fdm zv\u00fd\u0161en\u00edm pojistn\u00e9ho placen\u00e9ho st\u00e1tem<\/strong>, proto\u017ee je jej\u00ed vinou, \u017ee dovoluje u n\u011bkter\u00fdch profes\u00ed a u vybran\u00fdch pracovn\u00edk\u016f ve sf\u00e9\u0159e st\u00e1tn\u00edho vlivu mimo\u0159\u00e1dn\u00e9 p\u0159\u00edjmy a neu\u010dinila skoro nic pro systematick\u00e9 zv\u00fd\u0161en\u00ed ceny b\u011b\u017en\u00e9 pr\u00e1ce. N\u00e1sledovat mus\u00ed jako optim\u00e1ln\u00ed \u0159e\u0161en\u00ed v\u0161eobecn\u00e9 zv\u00fd\u0161en\u00ed ceny pr\u00e1ce o n\u011bkolik des\u00edtek procent<\/strong>. To vy\u0159e\u0161\u00ed v\u00edce probl\u00e9m\u016f, ne\u017e jen zdravotnictv\u00ed, a je to relativn\u011b snadno dosa\u017eiteln\u00e9, spot\u0159ebovalo by to v\u011bt\u0161\u00ed \u010d\u00e1st bezd\u016fvodn\u00fdch zisk\u016f a trochu nahradilo nedostate\u010dn\u00e9 zdan\u011bn\u00ed v\u00fdnos\u016f z podnik\u00e1n\u00ed. To ale ji\u017e nen\u00ed jen zdravotnick\u00fd, ale v\u0161eobecn\u00fd n\u00e1rodohospod\u00e1\u0159sk\u00fd probl\u00e9m.<\/strong><\/p>\n <\/p>\n <\/p>\n Praha 12.4.2016<\/p>\n Gr\u00e9mium Svazu pacient\u016f \u010cR<\/p>\n Ing. Josef Mr\u00e1zek, CSc. viceprezident<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Kl\u00ed\u010d k n\u00e1prav\u011b financov\u00e1n\u00ed ve\u0159ejn\u00e9ho zdravotnictv\u00ed Na co mus\u00ed m\u00edt ve\u0159ejn\u00e9 zdravotn\u00ed poji\u0161t\u011bn\u00ed pen\u00edze \u00dastava \u010cR ukl\u00e1d\u00e1 st\u00e1tu, aby zaji\u0161\u0165oval dostupnost zdravotn\u00ed p\u00e9\u010de pro ka\u017ed\u00e9ho ob\u010dana. Jde o rovn\u00fd p\u0159\u00edstup k pat\u0159i\u010dn\u00e9, to jest \u00fapln\u00e9 a kvalitn\u00ed p\u00e9\u010di,\u00a0 jak to bl\u00ed\u017ee ur\u010duj\u00ed dal\u0161\u00ed z\u00e1kony vy\u0161\u0161\u00ed pr\u00e1vn\u00ed s\u00edly. St\u00e1t odpov\u00edd\u00e1 za fungov\u00e1n\u00ed ve\u0159ejn\u00e9ho […]<\/p>\n","protected":false},"author":1,"featured_media":285,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14],"tags":[],"_links":{"self":[{"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/posts\/817"}],"collection":[{"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=817"}],"version-history":[{"count":6,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/posts\/817\/revisions"}],"predecessor-version":[{"id":857,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/posts\/817\/revisions\/857"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=\/wp\/v2\/media\/285"}],"wp:attachment":[{"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=817"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=817"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pacienti.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=817"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}P\u0159\u00edjmy ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed<\/strong><\/span><\/h4>\n
Ti, kdo volaj\u00ed po optimalizaci hospoda\u0159en\u00ed ve\u0159ejn\u00e9ho zdravotnictv\u00ed, by m\u011bli p\u0159edev\u0161\u00edm p\u0159ipravit sjednocen\u00ed v\u0161ech poji\u0161\u0165oven.<\/strong><\/span><\/h4>\n
<\/h5>\n
Ve ve\u0159ejn\u00e9m zdravotnictv\u00ed se nepl\u00fdtv\u00e1, dost\u00e1v\u00e1 jen 75 % p\u0159\u00edjm\u016f, kter\u00e9 mu n\u00e1le\u017e\u00ed<\/strong><\/h5>\n
Jak udr\u017eet l\u00e9ka\u0159e a zdravotn\u00ed sestry v republice<\/strong><\/span><\/h4>\n