David Rath may have survived the political wrangling that surrounded his appointment as the country's new health minister, but some analysts are questioning whether he can bring meaningful reform to a hurting health care system before next year's general election.

Rath, the former president of the Czech Medical Chamber (CLK), could be out of a job if the Social Democrats, who appointed him, fare poorly at the polls in roughly five months.

"It's a question if he will be able to make a significant impact in such a short period of time," says Pavel Kubícek, spokesman for the CLK and a doctor who works at the orthopedic clinic of Motol hospital.

The government appointed Rath health minister Nov. 4, and he now faces a health care system in crisis.

There is a growing disparity in this country, experts say, between the amount of money the government puts into the health care system and the high quality of care.

The Czech Republic is among the lowest spenders on medicine per capita in Europe, according to a recent Organization for Economic Cooperation and Development (OECD) report, although drug spending constitutes a quarter of the health care budget. The problem, say experts, is that doctors over-prescribe expensive medicines.

Is there enough time?

Rath has made clear that resolving the financial situation will be his priority. "I hope to deal with the financial crisis," he tells The Prague Post. "There won't be enought time before the elections to implement any major changes.

"I expect the president will do all he can to thwart any of my proposals," Rath adds.

Indeed, most major health care overhauls that Rath might suggest are unlikely to meet with support even among the Social Democrats.

Kubíček cites Rath's proposal to have patients play a greater role in financing their own health care as likely to be unpopular in the party.

But analysts point to Rath's assertiveness. "I wouldn't underestimate him," says Milan Znoj, director of the Political Science Institute at Charles University's Philosophical Faculty. "He's a very determined man."

Rath may need all the determination he can get if he is to placate the Czech Republic's underpaid, disgruntled doctors.

The doctors went on strike Oct. 6 protesting delayed payments from health insurance companies, in particular VZP, the country's largest provider. They called for then-Health Minister Milada Emmerová to step down. The government then sacked Emmerová.

Will Rath fare any better?

The opinion of health care workers on Rath is already divided. Some see him as a capable, charismatic leader who knows the health care system inside out — he has headed the ČLK since 1998 — and has clear ideas about what needs to change.

Others consider him to be an overly ambitious opportunist, who has put his political career above his professional one. Rath has been trying to forge a political career since the early 1990s, when as a 25-year-old doctor he tried to run for various Civic Democratic Party (ODS) positions without much success.

Tensions with Klaus

Recently Rath has been something of a political football thrown between President Václav Klaus and Prime Minister Jiří Paroubek.

Klaus repeatedly rejected Paroubek's nomination of Rath, on the grounds that if Rath remained president of the ČLK, he would have an undeniable conflict of interest.

When Klaus officially announced Rath's appointment at a modest ceremony at Prague Castle, the atmosphere was more than a little strained, according to those present.

Paroubek pushed for Rath in part because of his effort to assemble independent experts in the government — in much the same way that he was a champion of Deputy Prime Minister for the Economy Martin Jahn, before Jahn announced he would quit the government at the end of the year.

Rath left the ODS in 1994. Most political analysts agree that there exists an antipathy between Rath and Klaus, who headed the party at the time, that dates to this time.

But Rath further fueled tensions between the two recently by rejecting Klaus' conflict-of-interest concerns, even though he did eventually step down from his ČLK position.

"The president's dislike of Rath is publicly known," says Kubíček. "Once [Klaus] very undiplomatically announced that he would like to give Rath a good slap in the face."

According to Kubíček, Klaus is also negatively biased against the ČLK. "He always made it clear that he doesn't like the [ČLK] and that he considers it to be a lobbyist group," he says. "If Klaus had his way, the government would be the sole institution directing Czech health care."

But Alena Hromádková, a political science lecturer at Charles University, says that Klaus' behavior was justified.