Updated

PL

How the system works

Mechanisms.

We describe systemic mechanisms, not individuals: how the design of the system allows a narrow group to accumulate income from public funds — at the expense of patients and honest doctors.

Mechanisms
13
Questions
4
Updated
>1,600justified reports from patients in 2024Visits that never happened

01 · Transparency and oversight

Who checks what we pay for?

Almost nobody. NFZ inspections are selective, and nobody publishes the total of public payments to one doctor — since 2026 the state can calculate it, but does not disclose it. The only witness from outside the facility–Fund relationship is the patient: in 2024 patients filed almost 3,500 objections to entries in their Internet Patient Account (IKP), and more than 1,600 of them were found justified.

Mechanisms on this topic

~17%of the value of services is priced by the independent tariffPricing of healthcare services: who sets what the NFZ pays

02 · How the NFZ pays

What does the NFZ actually pay for?

For an entry in the system, valued in points — not for the visit itself. The independent tariff covers about 17% of the value of services; the payer sets the rest of the prices itself. When a price drifts away from the cost, some procedures become loss-making (a queue) and others a magnet for profit.

Mechanisms on this topic

~73%of specialists on contractsContract or employment: this decides what can be seen

03 · Forms of employment

Why can nobody see how much a doctor earns?

About 73% of specialists bill as a business, and nobody publishes the amounts of their contracts. The same doctor can have contracts in several facilities at once and paid standby, reachable by phone — each facility sees only its own piece.

Mechanisms on this topic

3doctors at a time per specialist training supervisor (4 by exception)Restricted access to the medical profession

04 · Access to the profession

Who decides how many doctors there are?

The Minister of Health sets the number of places in medical school and the pool of residencies, the CMKP (Centre of Postgraduate Medical Education) accredits training facilities, and one supervisor may train at most three doctors. The medical self-government gives opinions on the limits and opposes new programmes; whether restricting entry raises rates is, in Poland, a hypothesis.

Mechanisms on this topic

Tools

Check for yourself.

The mechanisms show up in the data: check the live queues at hospital emergency departments.

Live

Emergency department queues

A map of Polish emergency departments, refreshed every 10 minutes: how many wait for a doctor and whether within the standard. Triage and data limits.

What connects them

The common denominator: no transparency.

All these mechanisms have one thing in common: there is no register that adds up the public payments to one doctor. That is why our demand concerns transparency, not individuals. Every claim on the subpages has a publicly available source.

Editorial position

Public amounts, protected names.

We call on the state to publish, every quarter, the total pay of each person working in facilities with a National Health Fund (NFZ) contract — summed across all their workplaces, under a permanent identifier instead of a name.

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