Unexpected impact of changes in out-of-pocket payments for health care on Czech household budgets.

The Czech Republic is one of the countries that has a relatively low level of private spending on health. As a part of the health care reform package in 2008, some additional out-of-pocket payments were introduced, called 'user (patient) fees'. Furthermore, the government intends to increase some user fees in the following years. There have been serious discussions between proponents and opponents because an increase in out of pocket payments for health care may create financial obstacles for some households and restrict the desirable consumption of health care. The objective of this paper is to determine the impact of changes in out-of-pocket payments on household budgets and provide solution for more just distribution of the burden. Data from the household budget survey regularly collected by the Czech Statistical Office is used. Results showed that the burden of households increased from 2.15% of their net income to 2.63% in 2008 and to 2.55% in 2009 after the implementation of user fees. We noted that the presence of pensioners and elderly in a household was the factor which increased the overall burden the most and led to catastrophic payments.