Ing. Zdeněk Kabátek gained his managerial “spurs” in the private sphere and in the hospital in Písek. He has directly managed organisations within the Ministry of Health of the Czech Republic, and since 2012, he has been the director of the General Health Insurance Company (or Všeobecná zdravotní pojišťovna). He comes from South Bohemia and is moderately involved in adrenaline sports because he knows the value of health.
You manage the largest health insurance company in our country. The burden of the coronavirus pandemic, i.e. from a financial point of view, lies primarily on the shoulders of VZP. What key budgetary measures have you had to take in the last year? What decisions do you consider the most difficult from a managerial point of view?
It was undoubtedly a combination of many different measures. It is not possible to point to just one. Like many others, we reacted to a situation that no one here had any real experience of. And we had to act quickly — to keep the system stable, put resources where they were most needed and avoid collapse in segments that did not work directly with COVID. For example, we had to learn to minimise personal contact between patient and doctor. This was possible thanks to modern technology, and it was a valuable experience for us in terms of the development of telemedicine. In the VZP, we know today that tens of billions of Czech crowns will be in our final account for the pandemic, which, by the way, is not over yet. This is for testing, vaccinations, doctors’ bonuses, and, of course, patient care. In order to manage these costs, we have had to draw on our own financial reserves. And we were also greatly helped by the government’s immediate reaction, which immediately doubled the payments for the state insured. For the system, this meant around CZK 70 billion extra in total for healthcare. It has not been an easy 18 months for VZP, but we managed it. The Czech healthcare system stood up to the test, which, by the way, is excellent news for everyone. And it must be said that the greatest credit for this surely goes to the doctors, nurses and all the medical staff.
The COVID-19 pandemic is contrasted with obesity or cancer in terms of incidence. From the perspective of the General Health Insurance Fund, does the greater availability of COVID-19 treatment mean less availability of treatment for other, often more serious, diseases?
Certainly not from the point of view of VZP. The availability of treatment for any disease in our country is improving ear by year, which I can now confirm even despite the pandemic. This year alone, we will spend 232 billion Czech crowns to treat our clients. We have quantified that even for the most modern and, therefore, the most expensive centre-based care, our expenditure in the first half of the year has increased by 22% compared to the same period last year. This means that we can provide even the most difficult patients with the best medicines on the market. However, to come back to your question, from the point of view of the VZP, care is available to everyone without any restrictions.
This year, the European Commission presented its big plan to fight cancer. An expert debate is also taking place in the Czech Republic. What do you think is the most important thing in the EU and Czech cancer plans?
Cancer is a real problem for Europe. Only about one tenth of the world’s population lives here, but a quarter of all cancers in the world occur here. To some extent, this may be due to consistent diagnosis, but the fact is that it is a disproportion and a major threat in the future. Every year, 3.5 million people in the EU hear from their doctor that they have cancer, and 1.3 million people die of cancer every year in Europe. So it is certainly good that Europe has focused on this problem. If we now know quite reliably that 40% of cancers can be prevented by good lifestyle and prevention, I see the way forward as being to strengthen these areas in particular. And today, even more so, as the age of COVID has taken its toll on prevention, in the Czech Republic we have, unfortunately, had a drop of up to 200,000 preventive examinations for the most serious diagnoses last year. It is important to instil in people that taking responsible care of their health makes sense and can actually save their lives. This is, by the way, VZP’s strategy for the coming period also in terms of marketing strategy, i.e. the way we want to reach our clients. We should certainly focus on early diagnosis and the availability of the most modern medicines that are on the world markets. This is something we are managing to do quite well in the Czech Republic. Finally, I would perhaps add support for science and research on the old continent.
Every year around the world, October is Breast Cancer Awareness Month, the most insidious disease for women. Do you consider the availability of the latest therapies for breast cancer in the Czech Republic to be sufficient?
You are absolutely right, this type of cancer is definitely one of the most widespread in our country. And in the Czech Republic we can provide patients with the most modern and, therefore, the most costly therapy with innovative drugs. If I look at the problem in terms of numbers, last year alone, VZP paid for the care of 55,000 patients who became ill with this diagnosis. For the system, this means roughly CZK 2.2 billion.
Should the availability of healthcare be ensured evenly throughout the country? Do you cooperate on the structure of care with regional and city governments? And do you see the current distribution of Comprehensive Cancer Centres as sufficient?
Our approach takes access to care from cancer centres right through to the very last detail, focusing on ensuring that people have a specialist for serious illnesses as well as a GP or dentist on hand. We are always working with local administration — at the regional and city level they are a natural partner for us. And, of course, there is always room for improvement, and that includes care in these comprehensive centres. But we are on the right track.
Thank you for the interview
