Přehled o publikaci

This chapter examines the concept of fiscal space in the context of Czech healthcare financing, analysing its determinants, recent trends, and strategies for long‑term sustainability. Fiscal space — the capacity to increase sectoral funding without jeopardising fiscal stability — is explored through its theoretical foundations, revenue channels, and relevance to the Czech Republic’s hybrid Bismarck–Beveridge model. The analysis highlights the growing role of state payments for non‑working insured groups, which, while stabilising revenues during downturns, increase dependence on the state budget amid persistent deficits. International comparisons show Czech healthcare expenditure rising steadily as a share of GDP, positioning the country above regional peers but below Western European levels. The chapter outlines a two‑track strategy for sustainability: short‑term measures such as broadening the contribution base of public health insurance payments, improving procurement efficiency, optimizing both universal and optional care content, and maintaining reasonable balance of public budgets; and long‑term reforms including strengthened prevention, pharmaceutical policy reform, and clearer integration of private providers. The findings underscore that preserving universal coverage in the face of demographic ageing, cost pressures, and fiscal constraints will require both immediate revenue‑enhancing actions and structural efficiency gains to safeguard the fiscal space for a high‑performing healthcare system.