Healthcare spending in Poland has nearly tripled over the past decade, rising from PLN 107.6 billion in 2014 to PLN 293.6 billion in 2024. Yet patients continue to face long waiting lists and limited access to services. The SGH Think Tank for Healthcare report, A New Architecture for Healthcare Financing, argues that without stronger prevention and a change in the funding model, further increases in spending will not translate into better health outcomes or a reduction in lifestyle-related diseases.
According to the report, published in March this year, total healthcare expenditure in Poland accounted for 8.1% of GDP in 2024. Despite the nominal increase in spending, this level remains below the European Union average and places Poland near the bottom of the EU ranking.
“Most of the sector’s resources are concentrated on curative medicine—that is, on disease itself—while the very definition of a healthcare system suggests that the main priority should be preventing disease, so that it does not burden citizens in pursuing their responsibilities, ambitions and goals, nor burden the state system through the use of resources that must later be devoted to fighting illness,” Dr Małgorzata Gałązka-Sobotka, Dean of the Centre for Postgraduate Education and Director of the Healthcare Management Institute at Lazarski University, and co-author of the report, told Newseria.
An analysis cited in the SGH Think Tank report shows that in 2022, 88,000 people in Poland died from causes that could have been prevented through effective prevention, while a further 51,000 died from conditions that could have been avoided with appropriate medical intervention. This mortality rate was 45% higher than the EU average.
The report points out that preventive measures are poorly financed and lose out to spending on hospital treatment and highly specialised care. Their effects are also delayed and more difficult to measure directly. This applies both to secondary prevention, such as screening programmes, and to primary prevention, which is often overlooked and includes measures aimed at preventing diseases from developing in the first place, including those linked to lifestyle, diet and environmental conditions.
According to the expert, primary prevention must find its proper place in public policy.
“It requires building an entirely different living environment in which everything around us, from the first days of life, supports the possibility of living long and healthy lives. This requires a great many actions. In reality, every ministry has something to do in order to create a health-promoting living environment for citizens,” Gałązka-Sobotka says.
The report’s experts stress that a key condition for the success of this new approach is to elevate prevention to the level of government-wide coordination. Involving different ministries in the policy would also make it possible for prevention to be financed from their respective budgets.
“Today, we should examine those elements of public policy that need to be modified so that Poles are not encouraged by the actions of different industries to make choices that threaten their health. One example is the widespread advertising of highly processed food and broad access to such products, with virtually no restrictions for children and young people,” says the Dean of the Centre for Postgraduate Education.
“When it comes to prevention, we often talk about very simple interventions. One of them, which can significantly reduce the development of obesity among children and young people, is universal and broad access to drinking water in every educational institution and every public place.”
As she emphasises, this is one measure that does not require enormous investment but can make a meaningful contribution to prevention.
“Another example is changing the approach to promoting and popularising physical activity. Spontaneous movement should become a permanent element of public education,” the expert explains. “Choosing the stairs instead of the lift is another very simple example. We can do a great deal for our health here and now, without waiting for systemic regulation. However, without systemic regulation, it will certainly not be possible to build public policy and a living environment that genuinely supports health.”
The authors of the report propose, among other measures, creating a stable stream of funding for prevention, linked to long-term health goals and measurable outcomes. Their recommendations also include fiscal instruments, such as taxes on products harmful to health, as well as mechanisms that encourage people to undergo preventive examinations.
“Sin taxes are meant to increase consumer awareness of what they put in their shopping baskets. There is no doubt that healthy food is now significantly more expensive than highly processed food, whose impact on health is very negative. Through fiscal instruments, the state can change these relationships and make access to food that should form part of our everyday diet more democratic,” Gałązka-Sobotka says.
Since 1 January 2021, Poland has had a so-called sugar levy, also known as the sugar tax. The Sobieski Institute report Sugar: Poles’ Addiction cites data from the Market Monitoring Centre showing that the introduction of the levy contributed to significant price increases for sweet non-alcoholic beverages—by around 36% for carbonated drinks and nearly 22% for flavoured waters.
Demand for such products initially fell by around 20%, but consumers later became accustomed to the higher prices or changed their preferences. Actual revenues from the sugar tax have been significantly lower than forecast. The average Pole consumes nearly 45 kilograms of sugar per year, or approximately 125 grams per day.
“We were absolutely convinced that this was the right direction. At the time, we said openly that money from the sugar tax should be allocated to prevention, including consumer education, in order to compensate for the negative consequences of unhealthy dietary habits among Poles,” the expert says.
“Unfortunately, that did not happen. Revenue from the sugar levy went into the general budget of the National Health Fund and, regrettably, does not serve those purposes.”
A Warsaw Enterprise Institute report on the sugar levy, Concern for Health or a Cash Grab?, notes that 96.5% of revenue from the charge in Poland goes to the general budget. To a large extent, it therefore does not finance education, prevention or treatment of diseases resulting from poor dietary choices, including obesity and overweight, but is instead used for the National Health Fund’s general needs.
“Several years have now passed since the sugar levy was introduced, yet action in the area of obesity prevention and treatment remains far from what Polish society needs,” Gałązka-Sobotka stresses.
Data cited in the SGH report show that more than 53% of Poles are overweight and nearly 25% of the population is affected by obesity, with the problem increasingly affecting children. Around 5.6% of society lives with diabetes.
Poland’s VAT rules for water and beverages also remain controversial. Bottled water is currently subject to the standard 23% VAT rate, the same as carbonated drinks and alcohol. By contrast, beverages containing at least 20% juice benefit from a preferential 5% rate.
“I support increasing spending on both prevention and treatment, provided that we change the rules for allocating these funds and the way the healthcare system is organised. Without reforming primary prevention, secondary prevention and the patient pathway through diagnosis and treatment, further increases in funding may unfortunately result in spending much more money while delivering exactly the same healthcare that Poles find unsatisfactory,” concludes the report’s co-author.
