Following the public zloty.

Every month part of each salary goes to the National Health Fund (NFZ) as the health contribution. This text follows that zloty through four stops: from the contribution, through the Fund’s financial plan and the settlement with the hospital, to the doctor’s pay. At each stop we check what can be seen in public sources.

This is an overview, not a full description. Each stop has a separate text on this site — we refer to them where the details begin.

The further from the contribution, the less you can see: totals are public at every stop, the amount for one person — at none.

1. Stop 1

   Health contribution

   Transparency 3 out of 3: visible

   Employees and business owners pay a percentage of their income, farmers an amount per hectare, and for some people the state budget pays.

   Visible

   Rates set out in the act and aggregate amounts in the NFZ plan.

   Not visible

   Where your zloty will go — that is decided only at the next stops.

2. Stop 2

   NFZ plan

   Transparency 3 out of 3: totals visible

   The contribution, the subsidy from the state budget and smaller revenues go into a single financial plan of the Fund.

   Visible

   The plan and its amendments: total revenue and costs.

   Not visible

   The plan changes during the year, so an “NFZ budget” without the date of the version says nothing.

3. Stop 3

   Pricing and settlement with the hospital

   Transparency 1 out of 3: price visible, cost not

   The NFZ sets the price of services and pays the facility — hospitals in the hospital network mainly through a lump sum for the whole period.

   Visible

   Prices in orders of the President of the NFZ and in AOTMiT tariffs.

   Not visible

   What costs most prices were based on, and how much a single procedure actually cost.

4. Stop 4

   Payment to the doctor

   Transparency 0 out of 3: total per person not public

   The hospital pays the doctor a salary under an employment contract or — more often for specialists — an amount under a civil-law contract.

   Visible

   The statutory minimum for employees and aggregate AOTMiT data from individual facilities.

   Not visible

   The total paid to one person by several facilities. The state can collect it; citizens will not see it.

Stop 1. The contribution: who pays how much

An employee pays 9% of the contribution assessment base for health. Until the end of 2021 most of this amount, 7.75% of the base, could be deducted from tax, so about 1.25% was paid out of one’s own pocket. Since 1 January 2022 there has been no deduction.¹ The same reform also changed the rules of income tax, so how much the burden rose depends on income.

A farmer insured with the Agricultural Social Insurance Fund (KRUS) pays PLN 1 for each full conversion hectare (a unit that adjusts farm area for land quality). For farms smaller than 6 conversion hectares the contribution is paid by the state budget.² According to an analysis in the KRUS quarterly “Ubezpieczenia w rolnictwie” (“Insurance in Agriculture”), described by Farmer.pl, this applies to 60% of insured farmers, i.e. nearly 580,000 people (as of September 2025).³

In the draft NFZ plan for 2026 the contribution is PLN 184.3 billion (≈ €41.8 billion): PLN 179.8 billion (≈ €40.8 billion) comes in through the Social Insurance Institution (ZUS), PLN 4.5 billion (≈ €1.02 billion) through KRUS.⁴ The farmers’ part is therefore about 2.4% of the contribution, and even it includes amounts that the budget pays for smaller farms.

The most important point at this stop: the contribution is not enough. According to NIK, from 2021 to the first half of 2024 revenue from the contribution was always lower than the cost of healthcare services and covered between 90.3% and 96.26% of those costs. The audit office points to the growing role of other sources, above all the state budget.⁵ The draft plan for 2026 gives a similar proportion: PLN 184.3 billion (≈ €41.8 billion) of contribution against PLN 201.2 billion (≈ €45.7 billion) of costs of services, i.e. about 91.6% (our calculation).⁶

Stop 2. The NFZ plan: the contribution is not everything

The NFZ financial plan must be balanced — costs may not exceed revenue. In the draft for 2026, which the NFZ presented to the Sejm Health Committee in July 2025, revenue and costs are PLN 217.39 billion (≈ €49.3 billion) each.⁶

The contribution and the subsidy from the budget together give PLN 210.3 billion (≈ €47.7 billion). The missing amount of about PLN 7 billion (≈ €1.59 billion) is other revenue: a transfer from the Medical Fund (and a small amount from the Solidarity Fund), the sugar and alcohol levies, financial revenue and other revenue, including from EU programmes.⁶

In the draft plan for 2026 the contribution is about 85% of NFZ revenue, the subsidy from the budget about 12%, and other sources about 3%.

Revenue	PLN billion	Share
Health contribution (gross amount due)	184.35	84.8%
Subsidy from the state budget	26.00	12.0%
Medical Fund and Solidarity Fund	2.63	1.2%
Sugar and alcohol levies	1.80	0.8%
Financial revenue	0.29	0.1%
Other revenue (difference to the total)	2.32	1.1%
Total	217.39	100%

The plan, however, is a moving document. In September 2026 the Ministry of Health stated that the subsidy for 2026, originally planned at PLN 26 billion (≈ €5.9 billion), already stood at PLN 33.6 billion (≈ €7.63 billion). According to the ministry, the costs of the NFZ’s tasks rose from PLN 214.03 billion (≈ €48.6 billion) in the original plan to PLN 223.43 billion (≈ €50.7 billion) (as of 11 September 2026).⁷ The starting amount given by the ministry differs from the PLN 217.39 billion in the draft of July 2025, and the answer does not explain whether this is a different version of the plan or a different cost item.

The totals of the plan are public: the draft is discussed by a Sejm committee, and the Fund announces the amendments. The trouble is that an “NFZ budget” without the date of the version is easy to confuse — a figure from the summer of the previous year is out of date a few months later. We show the Fund’s revenue and costs in successive years in The National Health Fund budget.

Stop 3. Pricing and settlement: the price is public, the cost is not

Before the NFZ pays, it must know the price of a service. It was supposed to be calculated from costs by an independent agency, the Agency for Health Technology Assessment and Tariff System (AOTMiT). Where the Agency has not set a tariff, the price is set by the President of the NFZ in orders — and according to NIK, in 2015–2020 this applied to most of the value of services. The audit office also found that increases in prices were not based on a reliable analysis of costs, and that cost data come from the facilities themselves.⁸ We describe the figures and examples in Pricing of healthcare services.

A hospital in the hospital network is not paid for each procedure separately but receives a lump sum: an amount fixed in advance for the settlement period, the size of which depends on points reported earlier.⁹ The transfer therefore does not show how much a single procedure cost. How the 98% threshold in the hospital network lump sum works, when the NFZ pays for work above the limit and what audits check, we explain in How the NFZ pays hospitals.

Payment does not always come straight away. NIK described this using the example of unlimited services provided in the first half of 2024 above the amount in the contract. As of 17 September 2024, unpaid services of this kind that had not been waived were worth PLN 1.65 billion (≈ €375 million), and by 11 October 2024 the amount had fallen to about PLN 317 million (≈ €72 million). For earlier periods, from 2021 to the first quarter of 2024, arrears of this type amounted, as of the end of June 2024, to between about PLN 2 million and about PLN 91 million per period.⁵

NIK sees causes on both sides. Some facilities did not submit a request for payment, completed their reports after the deadline or did not accept the annex to the contract. The Fund took a long time to verify the data, and its regional branches had no free funds.⁵ In practice, as the audit office put it, “providers were lending money to the Fund” (our translation).

Stop 4. Payment to the doctor: here the trail ends

The hospital pays the doctor a salary under an employment contract or an amount under a civil-law contract, most often as a contractor. According to AOTMiT data from February 2026, 73.16% of specialists are paid under civil-law contracts, and the median monthly payment to a specialist under a single contract is PLN 25,595 (≈ €5,810) gross.¹⁰ Both figures concern contracts with a single hospital. We write more about them in Contract or employment and in the pay distribution.

Pay for employees is set by a public statutory minimum. Nobody collects contract amounts in one place, and a doctor working in several facilities appears in the data as several unconnected entries. Why the total for one person is not available in any public source, we describe in Lack of transparency.

Since 5 August 2026, however, the state has a tool to calculate this total. The minister of health may request from facilities data on the people who work in them, including the PESEL number, the licence to practise (PWZ) number, the form of employment and the amount of pay. The data may be passed to the NFZ and AOTMiT. Facilities, however, provide them only at the minister’s request, and the act does not provide for their publication.¹¹ The trail therefore ends for the citizen, not for the state. We discuss the provisions in our analysis The pay data act.

End of the route

At each of the four stops a total is visible: the contribution rate, the Fund’s plan, the price in an order, aggregate data on pay. At none of them can you see how much public money went in total to one person.

We do not call for a cap on pay or a ban on contracts. We call for the total payments from public money to each person to be public — under a permanent identifier, without names. The zloty’s route would then have a last stop that anyone can check.

Notes 11laws, data and statements we relied on

1. Commissioner for Human Rights (RPO), “Składka zdrowotna — brak możliwości odliczenia od podatku. Odpowiedź MZ” (“Health contribution — no possibility of deducting it from tax. Reply of the Ministry of Health”, in Polish) — contribution of 9% of the base; until 2021 a deduction of up to 7.75% of the base, abolished from 1.01.2022. ↩

2. KRUS, “Ubezpieczenia zdrowotne” (“Health insurance”, in Polish; gov.pl) — contribution of PLN 1 for each full conversion hectare; for farms below 6 conversion hectares the state budget pays. ↩

3. Farmer.pl, “Najnowsze dane KRUS: za 60 proc. ubezpieczonych składkę płaci państwo” (“Latest KRUS data: the state pays the contribution for 60% of the insured”, in Polish), 15.01.2026 — based on an analysis in the KRUS quarterly “Ubezpieczenia w rolnictwie” (“Insurance in Agriculture”), as of September 2025. ↩

4. Rynek Zdrowia, “Ponad 200 mld zł na zdrowie Polaków. Poznaliśmy plan finansowy NFZ na 2026 rok” (“Over PLN 200 billion for Poles’ health. We have seen the NFZ financial plan for 2026”, in Polish) — draft plan: contribution PLN 184.3 billion, of which PLN 179.8 billion from ZUS and PLN 4.5 billion from KRUS. ↩

5. Supreme Audit Office (NIK), “Realizacja zadań przez Narodowy Fundusz Zdrowia w latach 2021–2024” (“Performance of tasks by the National Health Fund in 2021–2024”, in Polish), May 2025 (KZD.430.5.2024, record no. 2/2025/P/24/046/KZD) — the ratio of the cost of services covered by the contribution, and unpaid unlimited services and their causes (pp. 89–90). The summary gives the PLN 1.65 billion figure as of 17.09.2024, the detailed part as of 23.09.2024. ↩ ↩² ↩³

6. Sejm, “Pełny zapis przebiegu posiedzenia Komisji Zdrowia (nr 88)” (“Full record of the Health Committee sitting (no. 88)”, in Polish), 9.07.2025 — statement by an NFZ representative on the draft financial plan for 2026: revenue PLN 217,388,948 thousand, contribution PLN 184,347,480 thousand, subsidy PLN 26,000,000 thousand, costs of healthcare services PLN 201,202,778 thousand, and the other revenue items. ↩ ↩² ↩³

7. Ministry of Health, answer to interpellation no. 19444 (in Polish), 18.09.2026 (DLF.050.97.2026.KK) — the subsidy for 2026 and the costs of the NFZ’s tasks after amendments to the plan. ↩

8. NIK, “Wycena świadczeń opieki zdrowotnej finansowanych ze środków publicznych” (“Pricing of publicly funded healthcare services”, in Polish), 2021 (KZD.430.002.2021, record no. 18/2021/P/20/055/KZD) — audit covering 2015–2020. These are the findings and assessment of the audit office, not a court ruling. ↩

9. Rynek Zdrowia, “Ministerstwo wyjaśnia sposób obliczania ryczałtu — zasady sieci szpitali i próg 98%” (“The ministry explains how the lump sum is calculated — hospital network rules and the 98% threshold”, in Polish), 18.09.2017. ↩

10. Rzeczpospolita, “625 lekarzy w Polsce zarabia powyżej 100 tys. zł. Dotarliśmy do wyliczeń” (“625 doctors in Poland earn over PLN 100,000. We have obtained the calculations”, in Polish), 27.05.2026 — AOTMiT data of February 2026: the share of civil-law contracts among specialists (73.16%) and median pay by form of employment. The data concern single contracts with a specific hospital. ↩

11. Act of 19 June 2026 amending the Act on publicly funded healthcare services and the Act on medical activity (in Polish; Dz.U. 2026 item 972), in force from 5.08.2026 — new wording of Article 27a of the Act on medical activity. ↩