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Henrieta Tulejová a Dajana Petríková: Verejných zdrojov v zdravotníctve je maximum, bez súkromných peňazí to ďalej nepôjde

1 h 8 min · 10 de abr de 2026
Portada del episodio Henrieta Tulejová a Dajana Petríková: Verejných zdrojov v zdravotníctve je maximum, bez súkromných peňazí to ďalej nepôjde

Descripción

Slovenské zdravotníctvo sa v posledných rokoch dočkalo výrazného nárastu zdrojov. Zvýšenie sadzby odvodov prinieslo do systému približne miliardu eur ročne navyše. V percentách HDP sa Slovensko dostalo na úroveň 8,4 percenta, čím sa takmer vyrovnalo Českej republike. Otázku, čo sme si za to kúpili, si v podcaste ozdravme kladú Henrieta Tulejová z Advance Healthcare Management Institute a Dajana Petríková z Asociácie zdravotných poisťovní. Ich diskusia vychádza z publikácie Zdroje pre budúce zdravie, ktorú Tulejová napísala spolu s Dominikou Šebovou, a zo záverov konferencie Zdravie ako investícia, organizovanej Asociáciou zamestnávateľských zväzov a združení v marci 2026. Stabilita personálu áno, lepšia starostlivosť nie Podľa Tulejovej sme si kúpili predovšetkým stabilizáciu personálu. Značnú časť rastu však pohltila inflácia. Zlepšenie kvality alebo dostupnosti starostlivosti sa zatiaľ nekoná. „Sme veľmi pravdepodobne na maxime toho, čo dokážeme tým súčasným systémom vygenerovať,“ upozorňuje Tulejová. Problém je v štruktúre – takmer všetko ide z verejných zdrojov a veľmi málo zo súkromných. „Aj ten štát má peniaze len z daní od pracujúcich. Takže v podstate je to stále jeden verejný zdroj, ale potrebujeme tam dať aj tie súkromné zdroje,“ dopĺňa Petríková. Nožnice sa otvárajú Publikácia Zdroje pre budúce zdravie [https://www.advanceinstitute.cz/publikace/zdroje-pre-buduce-zdravie] modeluje vývoj príjmov a výdavkov verejného zdravotného poistenia do roku 2070. Podiel pracujúcich na populácii bude klesať – do roku 2040 odíde do dôchodku okolo 300-tisíc ľudí zo silných ročníkov, pôrodnosť klesla na historické minimum 42-tisíc detí ročne. Tulejová vysvetľuje, že podľa projekcií sa už v roku 2030 otvorí medzera 120 eur na pacienta ročne medzi príjmami a výdavkami. „My sme sa snažili poukázať na to, že nepozeráme sa len na problémy, ktoré máme dnes pod nosom, ale poďme sa pozerať aj trochu viac do budúcna,“ hovorí. Konferencia AZZZ túto naliehavosť potvrdila – zamestnávatelia ako hlavní prispievatelia do systému verejného zdravotného poistenia upozornili, že rastúci nápor pacientov pri hroziacom úbytku personálu považujú za neudržateľný. 500 miliónov v neoficiálnych poplatkoch Medzitým v systéme živelne rastú neoficiálne poplatky v ambulanciách. „Tie poplatky v ambulanciách v posledných troch rokoch výrazne narástli a dneska sú niekde na úrovni 500 miliónov eur a ďalej rastú,“ uvádza Tulejová. Sedemdesiat percent pacientov by podľa prieskumu prijalo jednotné poplatky s ochranným stropom. „Ľudia veľmi volajú po tom, že poďme tie poplatky nastaviť jednotne. A hlavne poďme nastaviť nejakú ochranu, lebo cítia veľmi veľkú neistotu,“ dodáva. Aj konferencia AZZZ odporučila prestať sa tváriť, že zdravotníctvo je zadarmo, a namiesto toho poplatky upratať tak, aby boli transparentné a sociálne únosné. Tri piliere pre zdravotníctvo Petríková navrhuje trojpilierový systém po vzore dôchodkovej reformy. „Tak ako sme si okolo roku 2005 uvedomili, že nebudeme mať na tie dôchodky, niečo veľmi podobné potrebujeme urobiť aj v zdravotníctve,“ vysvetľuje. Prvý pilier by zostal solidárny a povinný. Druhý by bol povinne voliteľný s prvkami zásluhovosti. Tretí dobrovoľný, teda pripoistenie. Nominálne poistné: zdravotníctvo nie je zadarmo Tulejová presadzuje koncept nominálneho poistného po vzore Holandska, kde si každý platí fixnú sumu s dotáciami pre sociálne slabších. „Veľká výhoda toho princípu je, že každý jeden človek si začne uvedomovať, že zdravotníctvo nie je zadarmo,“ argumentuje. Zároveň uznáva, že takáto reforma si vyžaduje silnú spoluprácu ministra zdravotníctva a ministra financií a v Holandsku na to potrebovali dvadsať rokov. 80 nemocníc je príliš veľa Obidve diskutujúce zdôrazňujú aj potrebu efektívnejšieho využívania zdrojov. Slovensko má 80 nemocníc, porovnateľné Dánsko len 20. Pacienti po cievnej mozgovej príhode sú po akútnej liečbe odovzdaní rodinám bez dostatočnej rehabilitácie. Petríková pripomína, že poisťovne sú pripravené aktívne spoluvytvárať riešenia: „Tie dopady tej demografickej krízy ich vypnú už v nasledujúcom volebnom období. Preto si tých politikov pripravujeme, aby keď jedného dňa budú konfrontovaní s tou realitou, vedeli, že riešenia existujú.“ V podcaste hovoríme aj o týchto témach: •       💰 Slovensko sa v objeme zdrojov v zdravotníctve vyrovnalo Česku – dávame 8,4 percenta HDP, Česko 8,5 percenta •       📉 Za navýšené miliardy sme si kúpili stabilitu personálu, nie lepšiu starostlivosť – čakacie doby sa neskrátili •       👴 Do roku 2040 nám odíde do dôchodku 300-tisícľudí zo silných ročníkov, pôrodnosť klesla na historické minimum •       🏥 Máme 80 nemocníc, porovnateľné Dánsko len 20– päť pôrodníc funguje s jedným pôrodom denne •       💊 Nové technológie, robotická chirurgia aj inovatívne lieky tlačia na rast nákladov, ktoré nedokážeme pokryť •       🧾 Neoficiálne poplatky v ambulanciách narástli na 500 miliónov eur ročne a pacienti nevedia, koľko zaplatí •       ✅ 70 percent pacientov by prijalo jednotné transparentné poplatky s ochranným ročným stropom •       🏗️ Petríková navrhuje trojpilierový systém zdravotného poistenia po vzore dôchodkovej reformy •       🇳🇱 Tulejová presadzuje nominálne poistné po holandskom vzore – fixná suma pre každého s dotáciami pre slabších •       🧠 Pacienti po mŕtvici sú po akútnej liečbe odovzdaní rodinám bez rehabilitácie – chýba nám následná starostlivosť ‍

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