Jak przypomina „Gazeta Prawna”, minęło już siedem miesięcy, od kiedy ubezpieczyciele na mocy podatku Religi przekazują do Narodowego Funduszu Zdrowia środki na pokrycie kosztów leczenia ofiar wypadków drogowych. Jest jednak problem: szpitale wciąż nie otrzymały tych pieniędzy.
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NFZ tłumaczy, że przekazanie zgromadzonych pieniędzy świadczeniodawcom jest niemożliwe, ponieważ fundusz nie dysponuje informacjami z policji, pozwalającymi na identyfikację sprawców wypadków. Z kolei według policji nie można przesłać danych, dopóki nie zostanie ustalone, kto pokrywa koszty związane ze zmianą formatu informacji. Gazeta pisze, że problem ten jest spowodowany różniącymi się od siebie programami komputerowymi NFZ i policji, a resort zdrowia nie podjął dotychczas żadnych działań w celu jego rozwiązania.
„Gazeta Prawna” przypomina, że od 1 października 2007 r., czyli od momentu wejścia w życie ustawy wprowadzającej tzw. podatek Religi, ubezpieczyciele są zobligowani do przekazywania co miesiąc do NFZ 12 proc. przychodów z tytułu składki na ubezpieczenie OC komunikacyjne. Gazeta wylicza, że z tego tytułu do końca lutego na konto NFZ wpłynęło ponad 219 mln zł.
Katarzyna Lewandowska, dyrektor ds. produktów komunikacyjnych PZU SA mówi, że obowiązek ponoszenia kosztów leczenia ofiar wypadków drogowych został nałożony na wszystkich posiadaczy pojazdów niezależnie od tego, czy spowodowali wypadek, czy nie. W efekcie wprowadzenia podatku Religi ceny polis OC wzrosły ( PZU SA mimo wcześniejszych zapowiedzi o wzięciu na siebie całości kosztów ryczałtu na leczenie ofiar wypadków zmienił zdanie i od 1 kwietnia podniósł stawki tego ubezpieczenia o 10 proc. )
„Gazeta Prawna” pisze, że pomimo faktu, iż NFZ dysponuje środkami na leczenie ofiar wypadków pobranymi od ubezpieczycieli, oraz wzrostu cen OC, to jednak pieniądze te nie są wykorzystywane zgodnie z ustawą. Edyta Grabowska-Woźniak, rzecznik prasowy NFZ przyznaje, że przepisy ustawy uniemożliwiają prawidłowe rozliczanie świadczeń udzielonych przez szpitale ofiarom wypadków komunikacyjnych. Gazeta wskazuje przeszkodę uniemożliwiającą realizację tej kwestii: Fundusz nie dysponuje informacjami pozwalającymi na identyfikację danych sprawców i ofiar wypadków.
Tego typu dane NFZ powinien otrzymywać od policji, gdyż zgodnie z ustawą wprowadzającą tzw. podatek Religi, to właśnie ta ostatnia na wniosek NFZ raz na miesiąc powinna przekazywać dane osobowe sprawców i ofiar wypadków oraz informację o dacie i miejscu zdarzenia. Policja jednak tego nie robi. Krzysztof Hajdas z Komendy Głównej Policji tłumaczy, że problem polega na tym, iż nie zostało określone, kto ma zapłacić za zmianę formatu przesyłanych informacji.
„Gazeta Prawna” przypomina, że główną przesłanką przyświecającą projektodawcy przy wprowadzaniu podatku Religi było odciążenie budżetów szpitali. Miało ono polegać na pokrywaniu kosztów leczenia ofiar wypadków komunikacyjnych.
Marta Podgórska, rzecznik prasowy Szpitala Klinicznego nr 4 w Lublinie mówi, że świadczenia zdrowotne udzielane rannym często są bardzo drogie. Podgórska wyjaśnia, że ofiary wypadków trafiają do jej szpitala z wielonarządowymi obrażeniami i wymagają bardzo specjalistycznych zabiegów i badań.
Gazeta wylicza, że tylko w I kwartale tego roku karetki pogotowia z Powiatowego Zespołu Szpitali w Oleśnicy (woj. dolnośląskie) wyjeżdżały 278 razy do wypadków drogowych.
Agnieszka Cholewińska, zastępca dyrektora szpitala w Oleśnicy mówi, że ranni w tych zdarzeniach trafili na jej szpitalny oddział ratunkowy. Cholewińska dodaje, że koszty leczenia szpital pokrył z pieniędzy otrzymywanych na podstawie kontraktu z NFZ, a nie ze środków przesyłanych do Funduszu z firm ubezpieczeniowych.
„Gazeta Prawna” wskazuje, że tego typu sytuacja oznacza dla szpitali i jego pacjentów realne straty. Gazeta wymienia: 1. Fundusz płaci za leczenie ofiar wypadków nie na podstawie rzeczywistych kosztów ich leczenia, ale kierując się własną wyceną świadczeń. 2. w sytuacji, gdy koszty leczenia rannych są pokrywane przez szpital ze środków uzyskiwanych na podstawie kontraktów z NFZ, placówka może wykonać mniej zabiegów planowych. W konsekwencji owstają coraz dłuższe szpitalne kolejki.
„Gazeta Prawna” informuje, że tak NFZ, jak i firmy ubezpieczeniowe oraz świadczeniodawcy oczekują na zmianę wadliwych przepisów. Jednak Ministerstwo Zdrowia, mimo tego, że dysponuje informacjami o braku funkcjonowania zmienionego systemu finansowania leczenia ofiar wypadków komunikacyjnych, to wciąż jednak nie ma gotowej propozycji nowelizacji ustawy. Według informacji uzyskanych przez gazetę z biura prasowego resortu zdrowia dopiero po uzyskaniu informacji z Funduszu o finansowaniu i rozliczaniu tych świadczeń zostaną rozpoczęte prace legislacyjne w tym zakresie.
( źródło: „Gazeta Prawna” z 8.05.2008 r. )
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