The Czech Health Ministry is preparing changes to the law aimed at adapting the healthcare system to what officials describe as the fastest population ageing in the country’s history. “Prevention” is the operative word in the new strategy, with bonuses for preventive screenings. However, many remain unconvinced that the plan will bring results.
Heart disease and cancer are the leading causes of death in the Czech Republic, yet participation in routine check-ups and screening programs remains relatively low.
Around 40 percent of women do not undergo screening for cervical and breast cancer, while seven in ten people avoid colorectal cancer screening, even though such examinations are fully covered by health insurance once patients reach the relevant age.
More than 3,000 people die from colorectal cancer in the Czech Republic each year, with many deaths considered preventable through earlier detection.
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This information is particularly significant as the healthcare system faces mounting pressure from demographic change. By 2035, the number of seniors whose health insurance contributions are paid by the state is expected to rise by around 800,000, while the number of employed paying health insurance is projected to fall by about 700,000.
The Health Ministry says this shift will require fundamental changes to how healthcare is organised and delivered and is planning a major shift towards preventive care to help contain healthcare costs in the longer term. Diseases found at an earlier stage are generally easier and less expensive to treat. Prostate cancer, for example, currently costs the healthcare system around CZK 2.5 billion a year, according to a senior Health Ministry official.
To encourage people to make use of preventive services, the ministry is considering financial incentives of between CZK 500 and CZK 1,500 for those who complete the relevant examinations in the age bracket 45 to 65. Each health insurance company would decide how much to offer, and the payment would be made automatically without patients having to apply for it.
The screenings currently under consideration include the early detection of dementia and screening for breast, prostate and colorectal cancer.
Jan Zapletal, who heads the ministry’s health insurance department, outlines the likely expenditures
“According to our calculation, around 1.1 million people would currently meet the eligibility criteria. With a financial bonus in sight, that number could grow. Right now the scheme could cost between CZK 550 million and CZK 1.65 billion, depending on the amount paid.”
He argues that even if that sum grows, it will still be less expensive for the state to treat serious illnesses at an early stage.
Doctors say the proposal could help, but caution that financial rewards alone are unlikely to persuade people who feel healthy and have no immediate medical concerns to visit their doctors. They argue that raising public awareness about the importance of prevention is equally important.
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The draft bill is to be presented to the Chamber of Deputies next year in view of a roll-out in 2028. Even now, the idea of financial incentives for prevention has sparked controversy. Some opposition politicians have described the plan as populist or risky. Michaela Šebelová from the Mayors and Independents says this is not something she would support.
“This is just another populist gimmick which will deepen the state deficit without any guarantee of bringing the desired effect.”
Critics also question whether direct cash payments are the right form of incentive, noting that the money could ultimately be spent on products such as alcohol or tobacco. Existing health insurance vouchers, by contrast, are generally restricted to health-related services and activities promoting an active lifestyle with some insurers giving reimbursements for specific health-related expenditures such as gyms, or vaccines.