Czech court upholds health fees,key part of reform

                                
 By Jan Lopatka
                                
 PRAGUE, May 28 (Reuters) - Czech patients will have to pay
for doctor visits, the country's top court ruled on Wednesday,
upholding the cornerstone of the centre-right government's plan
to reform the public health system and cut waste.
                                
 The 30-crown ($1.87) fee and other planned reforms have
rankled many Czechs accustomed to free health care after decades
of communist rule, sparking unrest in the ruling coalition and
drawing a strike threat by labour unions.
                                
 The Constitutional Court struck down a petition backed by
the Social Democrat opposition against the fees, saying the
payments -- just a little more than the cost of a metro ticket
-- were a political matter.
                                
 "If the court proceeded, in relation to any reform, with too
much activism, it would create (a precedent) which would close
the door to any reform efforts," judge Stanislav Balik said.
                                
 The fees, an element of the government's wider fiscal,
welfare and pension reforms, reduced the amount health insurers
spend on prescriptions by 20 percent, or $104 million, in the
first quarter. Many Czechs used the state-organised system to
get easily available drugs like aspirin for free.
                                
 The payments also significantly cut doctor visits since
their introduction in January. The Health Ministry said savings
generated by the new system would be channelled toward patients
requiring expensive care.
                                
 But like elsewhere in central and Eastern Europe where
governments are trying to overhaul public services designed in
the communist era, the fees have met widespread resistance from
the public and caused deep divisions in the ruling coalition.
                                
 The Christian Democrats, a junior member of the three-party
coalition, have demanded children and pensioners be exempt and
have threatened to block further reforms like the transformation
of health insurers into for-profit companies.
                                
 Unions have called a general strike for June 24 and the
country's top university threatened to close its medical schools
unless the proposed steps are changed.
                                
 The court ruling was eagerly anticipated by the government,
which had previously criticised the court for striking down a
law which withheld sickpay in the first three days of illness, a
measure aimed at cutting absenteeism.
                                
 In neighbouring Hungary, doctor fees were struck down in a
referendum which halted reforms and broke up the ruling
coalition. In Slovakia, the leftist government of Robert Fico
cancelled fees introduced by the previous administration.
 (Reporting by Jan Lopatka; Editing by Michael Winfrey and Jon
Boyle)