One or More Payers for Healthcare Financing: The Experience From Poland and Czechia

Abstract This paper focuses on circumstances and consequences of health payers' configuration in Poland and Czechia since the 1990s. It aims to identify the differences in healthcare financing between the two neighboring countries that had started from a similar position, but eventually incorporated different arrangements of payers. The paper conducts comparative analysis of four distinctive elements: the configuration of contracting and payment methods, the power of the payers, coverage and contributions, and the dominant anchor's search attempts. The results map the evolution of healthcare in both countries with a focus on the payers' role, show the payers' economic position and behavior to providers, citizens and health policy authorities. Polish single‐payer system was identified as cheaper and more effective for administratively based expenditure control, while the Czech multipayer one showed higher institutional stability and a wider coverage paid by public health insurance. The paper brings an empirical assessment of existing theoretical knowledge concerning the options for a payers' configuration, demonstrating that the choice and adjustments thereof are country‐specific and depend on the preferred priorities of health policy.