Ústavný súd ČR zvolal verejné jednanie o úhrade zdravotníckych prostriedkov | Medicínske právo
              

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Ústavný súd ČR zvolal verejné jednanie o úhrade zdravotníckych prostriedkov


 | 1.5.2017 | komentárov: 290

Ústavný súd zvolal na 10. mája verejné jednanie pléna z dôvodu, ako zdravotné poisťovne stanovujú výšku úhrad zdravotných prostriedkov. Podľa návrhu skupiny senátorov, podaného už v roku 2015, je súčasný systém netransparentný a neústavný. Verejné jednanie pléna sú výnimočné, niekoľko rokov sa žiadne nekonalo.

Obrazok

Kto sa za rezort jednania zúčastní, určí minister. Medzi zdravotnícke pomôcky patria napríklad vozíky, barle, slúchadlá, šošovky a množstvo ďalších sofistikovaných pomôcok. Podľa stanoviska súdu sa chce plénum zoznámiť s praxou zdravotných poisťovní, práve preto sa pravdepodobne uskutoční verejné jednanie s dokazovaním, nakoľko súd obvykle zvoláva iba verejné vyhlásenie nálezu.

Minulý rok sa po trojročnej pauze v súdnej sieni konalo verejné pojednávanie ohľadom sťažnosti spochybňujúcej zákonnosť rozvrhu práce Krajského súdu v Brne. Išlo však o jednanie trojčlenného senátu, nie celého pléna, teda zboru všetkých ústavných sudcov. Pred rokmi plénum jednalo verejne pomerne často, najmä keď na tom trvali účastníci konania, potom však novela zákona nechala zvolanie verejného jednania úplne na úvahe sudcov.

Podnet dvoch desiatok členov senátu obdŕžal súd vo februári 2015. Sporná časť zákona o verejnom zdravotnom poistení hovorí, že zdravotnícke prostriedky sa hradia vo výške 75 % ceny „ v prevedení najmenej ekonomicky náročnom“. Poisťovne pri určení
ceny používajú prieskum trhu. Podľa hovorcu všeobecnej zdravotnej poisťovne Oldřicha Tichého sa všeobecná zdravotná poisťovňa riadi platnou legislatívou. Vyjadril sa, že pokiaľ to niekto napadá, je to jeho právo, Ústavný súd nejak rozhodne a všeobecná zdravotná poisťovňa bude rozhodnutie rešpektovať.

Podľa členov senátu by mal zákon jednoznačne popisovať procedúru stanovenia výšky konkrétnej pomôcky. Súčasná úprava vraj dáva poisťovniam príliš voľnú ruku.
Pacienti, dodávatelia, ani poskytovatelia služieb prakticky až do publikovania tzv. cenníka nevedia či vôbec prípadne v akej výške bude konkrétna zdravotnícka pomôcka hradená. Členovia senátu upozornili, že poisťovne tak vlastne rozhodujú o miliardách korún z verejného zdravotného poistenia. Podľa členov senátu neexistuje efektívna možnosť prieskumu a kontroly tejto činnosti zdravotných poisťovní zo strany dotknutých subjektov ( pacientov, poistencov, dodávateľov a poskytovateľov zdravotných služieb). Práve tieto všetky aspekty činia celý systém úhrady zdravotníckych prostriedkov netransparentnými a neústavnými .Členovia senátu navrhuje
aby súd zasiahol aj do prílohy zákona, kde sú definované a aplikované dva rôzne typy úhradových limitov A a B.


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