Institutional Conditions for Improving the Efficiency of the Health Care System in Poland

Abstract

The health care system in Poland requires thorough institutional changes. Problems occurring therein cannot be tracked down merely to a lack of funds. Institutional analysis based on the achievements in various fields can reveal a number of reasons for inefficiency of the system by referring to transaction costs, agency costs and costs associated with the transfer of property rights. This applies not only to relationships and contracts between the patient and the doctor, but also between all the actors involved in the process of redistribution and service. System optimization and reducing inefficiencies should be applied to contract analysis and is based on the comparative approach to indicate the best possible solution in terms of efficiency. It is important to adopt a holistic approach, draw on the achievements of different scientific disciplines, and expand the economic analysis of qualitative factors that relate to the sociological phenomena of human behavior and psychology. The identified institutional shortcomings of the current health care system cannot be remedied without applying complementary solutions that shall reduce the formation of the so-called externalities. Today, it is difficult to talk about the health services market, since many of these services are contracted without taking into account the criterion of quality and the results achieved. The existing health care system’s asymmetry of information reveals a number of opportunistic behaviors and phenomena characteristic of the agency problem. An attempt to identify and assess the magnitude of transaction costs and agency costs seems to be a challenge. However, it seems to be, in addition to the governance structure and managerial competencies, the main source of inefficiency in health care in Poland.