Central European private spending on health to exceed €21bn

Private healthcare markets in Central Europe are still young markets replete with opportunities. There is substantial demand for such services in the countries analysed in the most recent PMR report “Private healthcare market in Central Europe 2016. Development forecasts for 2016-2021” because of the rise of the middle and upper classes and the increase in demand from such groups for quality and patient care, which, combined with the long queues in public healthcare, render private facilities increasingly attractive. On the other hand, the market could soon encounter some glass ceilings, represented by, for example, the lack of appropriate legislation in the area of private insurance.

Poland accounts for half of the private healthcare market in Central Europe

Poland and Hungary account for the most substantial proportions because of the relative affluence of society, the large populations, and the relatively efficient reforms (Poland), along with the substantial amount spent on drugs (Hungary). Between 2015 and 2021, Slovakia and the Czech Republic will record the most substantial reductions in market share in the wake of unfavourable reforms. This will also pertain to Hungary.

Romania and Bulgaria to grow at the fastest pace in 2016-2021

The most substantial growth figures will be recorded in Romania, Bulgaria and Poland, because of the low saturation and the investment boom. Interestingly, the average growth forecast for 2016-2021 is more cautious than that for 2015-2020 because of the prolonged lack of important reforms which liberalise healthcare markets in the majority of countries, and whole forecasts for the Czech Republic and Slovakia are now a little better because of the improving economic situation.

Private insurance still waits in anticipation of proper legislation in Central Europe

So far, little has changed in the arena of private insurance, although some governments are working on legislation pertaining to complementary health insurance (but none are taking the competition between private and public insurers in the area of compulsory insurance into account):

In Bulgaria in 2012 voluntary health insurance was transformed into general insurance. In summary, voluntary health insurance services are currently provided by general insurance and life insurance companies. What is more, in June 2016 the Bulgarian government has approved draft changes to the Law on Health Insurance, according to which the medical care reimbursed by the NHIF will be divided into two packages – basic and complementary, in 2017.

In Hungary because of a regulatory limitation of the range of products which can be funded by voluntary health insurance, an increasingly substantial number of people have been voicing scepticism about the value of being a member of so called health funds. The regulation, which allowed only the purchase of curative products via funds accumulated by the voluntary health insurance organisations (rather than the purchase of preventive products, which had been permitted beforehand), came into force in 2006. In January 2015, Gabor Zombor, the secretary of state for healthcare, said that the government would not oppose the appearance of private insurers on the Hungarian market if their activities continue to supplement the social security system.

A debate about the introduction of complementary health insurance has continued in Poland for several years. Several options have been discussed within this scheme, including a bold proposal to decentralise the NFZ and allow private health insurance companies to compete with the NFZ on equal terms (2008), and a suggestion that tax deductions for policy holders (2009 and 2011) be introduced. In recent years the solutions proposed in the area of health insurance have been more conservative, but none of them have been implemented. With regard to the policy of the current government in general, a strengthening of the positions of private health insurance companies is not expected – the new system is more likely to be built on the basis of the public payer. 

In Romania since 1 July 2016 deductions for health insurance have risen from €250 to €400 per year, for both employers and employees. As previous governments failed to enact the appropriate law, at the beginning of 2016 the ASF announced that it would try to convince decision makers that partial liberalisation of the health system was necessary and that complementary and voluntary insurance must exist alongside obligatory insurance.

Methodology notes

Private healthcare market value in the report consists of (unless indicated otherwise):

cost of rehabilitation, diagnostic tests and doctor’s appointments covered directly from patients’ pockets, subscriptions offered by medical companies together with occupational healthcare serviceshealth insurance offered by insurance companies, spending on drugs and other healthcare products, spending of non-profit organisations.