20. září 2016 | News

Ministerstvo zdravotnictví hájí zájmy lobbistických skupin

In force since July, the Contract Register Act runs counter the interests of pharmaceutical companies, healthcare supply providers, and lobbyists in control of the Czech healthcare system. The legislation makes it compulsory to disclose contracts with public institutions through a central information system. Moreover, disclosure shall be a mandatory requirement for contracts to become applicable, from mid-2017. Concealing the contents of contracts is a vested interest of lobbyist groups. The Ministry of Health has met their interests more than halfway and issued recommendation that certain provisions of contracts should not be made public. In this way the ministry covers up non-transparencies over the payment of bonuses, provision of presents and the routine of siphoning funds off from the public health insurance system.    

In May the Ministry of Health hosted a meeting of representatives of pharmaceuticals, large-scale drug distributors, hospitals, suppliers of healthcare products VZP health insurance company and the Association of Health Insurers. They discussed the “sensitivity” of contract provisions that could jeopardize their trade secrets if disclosed in the register (click here)…

Such “sensitive” provisions comprise, among others, the size of bonuses for the volume of medical products supplied to a hospital (and the mechanism of its determination), or the amount of product price rebate). The Ministry recommended the non-disclosure of in particular any information about the bonus calculation mechanism (rebates) and related conditions of payment. Why quantity bonuses? Health insurers refund the prices for which hospitals buy medicines (healthcare products) from suppliers. If such refunds are sufficiently overprices, the supplier can in time return to the hospital a part of the price for his “goods”. However, the hospital will not return the (often considerable) funds to the insurer and keep it for its own purposes. These funds can be expended at will, meaning often uneconomically. It is essentially a type of insurance fraud. Demonstrably, bonuses sometimes made up for more than 40 percent of the original price (here). The insurer-refunded price could have been smaller for at least the said percentage and hospitals would be poorer for that. In another variant, the supplier does not grant a bonus to the hospital and keeps everything, or gives but a fraction of what he could have given…  

The amount of gift from a pharmaceutical company to the hospital is also considered a sensitive contract provision, as are the purpose of the gift and the conditions of payment. The Ministry therefore advices hospitals to render sensitive information illegible before including it in the register. There is no sensible reason for concealing the purpose of a gift to hospital, unless it is problematic, illegal or criminal.

“The Ministry’s approach resembles a restaurant that advises the waiter how to secretly cheat the customer…,” says Anticorruption Endowment analyst Martin Soukenka.

The Anticorruption Endowment is a fully independent initiative by people radically unprepared to accept a high level of corruption in state administration. One of our goals is to help expose corruption in state administration and support projects exposing corruption.  

Contact please: Martin Soukenka, NFPK Analyste-mail: martin.soukenka@nfpk.cz