Stenogram Sejmu · 2026-06-19

Elżbieta Anna Polak

Kadencja 10 · posiedzenie 60 · wypowiedź 72

Klub podany w głosowaniu imiennym tego posła w tym samym dniu i posiedzeniu: KO · dowód głosu. Nie jest to pełna historia członkostwa.

Pełna wypowiedź

10. kadencja, 60. posiedzenie, 3. dzień (19-06-2026) 27. punkt porządku dziennego: Pierwsze czytanie poselskiego projektu ustawy o systemie ochrony zdrowia oraz o zmianie niektórych innych ustaw (druk nr 2673). Poseł Elżbieta Anna Polak: Panie Marszałku! Panie Ministrze! Wysoka Izbo! Nikt z nas nie ma żadnych wątpliwości, że w polskim systemie ochrony zdrowia potrzebne są zmiany, bo pomimo kilkudziesięciu miliardów wzrostu nakładów na ochronę zdrowia - w tym roku, przypomnę, to jest 250 mld, na przyszły rok plan to 270 mld - problemy nadal pozostają, nie są rozwiązane. Dlaczego mamy te problemy? Lista grzechów jest długa. Przede wszystkim dziura w budżecie Narodowego Funduszu Zdrowia. Na koniec 2023 r. to blisko 20 mld zł. Do tego zastaliśmy wysokie zadłużenie szpitali, które wzrosło za rządów Prawa i Sprawiedliwości dwukrotnie. Na koniec 2023 r. to już były prawie 23 mld zł. Automatyczny wzrost wynagrodzeń wprowadzony przez rząd Prawa i Sprawiedliwości to są koszty w tym roku blisko 70 mld zł łącznie na te podwyżki. Od 1 lipca państwo zafundowaliście kolejne prawie 9%, za które też trzeba będzie zapłacić. Poza tym Narodowy Fundusz Zdrowia został obciążony kosztami bezpłatnych leków bez środków dodatkowych na ten cel, świadczeniami, kosztami świadczeń wysokospecjalistycznych. Proszę państwa, musimy sprostać przede wszystkim wyzwaniom demograficznym. Utrzymywanie w dalszym ciągu tylu łóżek, tylu szpitali, również powiatowych, bez ich konsolidacji i bez wprowadzenia reformy jest niemożliwe, będzie pogłębiało deficyt, wydłużało kolejki. Przedstawiony poselski projekt ustawy prezentuje cztery obszary, w których są konkretne propozycje naprawienia czy też zmiany tego systemu. Po pierwsze, integracja zarządzania ryzykiem choroby i procesem leczenia. Ta propozycja obejmuje przeniesienie z ZUS do Narodowego Funduszu Zdrowia kompetencji związanych z zarządzaniem świadczeniami pieniężnymi z tytułu czasowej niezdolności do pracy. Celem tej zmiany jest stworzenie bodźców do optymalizacji procesu leczenia. W obszarze drugim to racjonalizacja kosztów wynagrodzeń w sektorze ochrony zdrowia, do czego już przystąpiliśmy, przyjmując dzisiaj właściwą ustawę, która stworzy narzędzia do monitorowania wynagrodzeń na podstawie PESEL-u, tak żeby nie dochodziło do nieprawidłowości. Po trzecie, to zmniejszenie obciążeń pacjentów i zwiększenie transparentności systemu. Projekt zakłada wprowadzenie ulgi zdrowotnej w kwocie 10% poniesionych i udokumentowanych kosztów rehabilitacji, zakupu wyrobów medycznych, świadczeń zdrowotnych i usług opiekuńczych. Ulga będzie przysługiwała na wydatki poniesione na rzecz podatnika, jego krewnych w linii prostej, rodzeństwa, członków rodziny we wspólnocie domowej lub innych na utrzymaniu, wyłączenie u pracowników z przychodu podlegającego opodatkowaniu świadczeń zdrowotnych i rehabilitacyjnych sfinansowanych przez pracodawcę w formie abonamentu zdrowotnego. Co istotne, ta ustawa zakłada również wprowadzenie instytucji koordynacji opieki szpitalnej przez szpitale wiodące. Wydaje się to bardzo interesujące. Mogę to powiedzieć z mojej perspektywy, z perspektywy moich doświadczeń jako byłego marszałka województwa, gdzie rozproszenie tej odpowiedzialności i kompetencji też jest dużą barierą w sprawnym funkcjonowaniu systemu ochrony zdrowia. Celem proponowanych zmian jest przede wszystkim poprawa stabilności finansowej systemu, zwiększenie efektywności zarządzania, zmniejszenie obciążeń finansowych pacjentów, ale przede wszystkim zwiększenie transparentności i ograniczenie szarej strefy. Dzisiaj widzimy, jakie są problemy, które są pokazywane jako patologie, jako nieprawidłowości, które musimy absolutnie wyeliminować z systemu ochrony zdrowia. Stąd też w imieniu klubu Koalicji Obywatelskiej chciałabym zapewnić wnioskodawców, że warto pochylić się nad tym projektem. Powinniśmy pracować merytorycznie ponad podziałami politycznymi, ponieważ system ochrony zdrowia dotyczy nas wszystkich, naszych rodzin. Musimy sprostać tym wyzwaniom. Rekomendujemy dalsze prace nad przedłożonym projektem ustawy. Dziękuję. (Oklaski) Przebieg posiedzenia

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Kontekst w stenogramie

1. (4.14ms; exec 4.1 + fetch 0.05; rows 1) SELECT s.object_id AS statement_id, s.statement_number, s.speaker_name, s.source_member_id, mp.object_id AS member_id, d…

2. (1.51ms; exec 1.49 + fetch 0.03; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extracti…

3. (1.33ms; exec 1.31 + fetch 0.02; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6761 ORDER BY ordinal

4. (1.14ms; exec 1.12 + fetch 0.02; rows 4) SELECT statement.object_id, statement.statement_number, statement.speaker_name, dayStatement.ordinal FROM sejm_transcrip…

5. (1.4ms; exec 1.39 + fetch 0.01; rows 1) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.obje…

6. (1.24ms; exec 1.23 + fetch 0.01; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extracti…

7. (0.94ms; exec 0.92 + fetch 0.01; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6759 ORDER BY ordinal

8. (1.67ms; exec 1.66 + fetch 0.01; rows 1) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.obje…

9. (1.59ms; exec 1.57 + fetch 0.02; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extracti…

10. (1.03ms; exec 1.01 + fetch 0.01; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6760 ORDER BY ordinal

11. (1.29ms; exec 1.28 + fetch 0.01; rows 1) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.obje…

12. (1.4ms; exec 1.39 + fetch 0.01; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extracti…

13. (1.32ms; exec 1.3 + fetch 0.02; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6762 ORDER BY ordinal

14. (1.73ms; exec 1.72 + fetch 0.02; rows 1) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.obje…

15. (1.2ms; exec 1.18 + fetch 0.02; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extracti…

16. (0.96ms; exec 0.94 + fetch 0.01; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6763 ORDER BY ordinal

17. (11.05ms; exec 10.94 + fetch 0.11; rows 17) SELECT individual.raw_club, individual.evidence_id, f.requested_url FROM sejm_individual_votes individual JOIN sejm_vote…

1. (4.14ms; exec 4.1 + fetch 0.05; rows 1) SELECT s.object_id AS statement_id, s.statement_number, s.speaker_name, s.source_member_id, mp.object_id AS member_id, day.object_id AS day_id, day.term, day.proceeding_number, day.source_date, day.current_revision_id AS day_revision_id, dayStatement.ordinal, dayEvidence.id AS list_evidence_id, dayEvidence.selector_type AS list_selector_type, dayEvidence.selector AS list_selector, dayFetch.id AS list_fetch_id, dayFetch.requested_url AS list_source_url, dayArtifact.sha256 AS list_sha256, binding.artifact_id, binding.evidence_id AS transcript_evidence_id, transcriptEvidence.selector_type AS transcript_selector_type, transcriptEvidence.selector AS transcript_selector, transcriptFetch.id AS transcript_fetch_id, transcriptFetch.requested_url AS transcript_source_url, artifact.sha256 AS transcript_sha256, artifact.detected_mime, artifact.byte_size FROM sejm_statements s JOIN sejm_transcript_days day ON day.object_id = s.transcript_day_id LEFT JOIN sejm_mp_identities mp ON mp.term = day.term AND mp.mp_number = s.source_member_id LEFT JOIN sejm_transcript_day_statements dayStatement ON dayStatement.day_id = day.object_id AND dayStatement.day_revision_id = day.current_revision_id AND dayStatement.statement_id = s.object_id LEFT JOIN evidence dayEvidence ON dayEvidence.id = dayStatement.evidence_id LEFT JOIN fetches dayFetch ON dayFetch.id = dayEvidence.fetch_id LEFT JOIN artifacts dayArtifact ON dayArtifact.id = dayEvidence.artifact_id LEFT JOIN documents document ON document.owner_object_id = day.object_id AND document.document_kind = 'statement_transcript' AND document.source_document_key = CONCAT('sejm:statement:', s.statement_number) LEFT JOIN document_versions version ON version.document_id = document.object_id AND version.sequence_no = (SELECT MAX(latest.sequence_no) FROM document_versions latest WHERE latest.document_id = document.object_id) LEFT JOIN document_version_artifacts binding ON binding.version_id = version.object_id AND binding.role = 'html' AND binding.current_selector_sha IS NOT NULL LEFT JOIN evidence transcriptEvidence ON transcriptEvidence.id = binding.evidence_id LEFT JOIN fetches transcriptFetch ON transcriptFetch.id = transcriptEvidence.fetch_id LEFT JOIN artifacts artifact ON artifact.id = binding.artifact_id WHERE s.object_id = 23111 LIMIT 1

2. (1.51ms; exec 1.49 + fetch 0.03; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extraction.run_id WHERE extraction.source_artifact_id = 25410 AND run.state = 'completed' ORDER BY CASE extraction.quality_state WHEN 'success' THEN 0 WHEN 'unreadable' THEN 1 ELSE 2 END, run.finished_at DESC, extraction.id DESC LIMIT 1

3. (1.33ms; exec 1.31 + fetch 0.02; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6761 ORDER BY ordinal

4. (1.14ms; exec 1.12 + fetch 0.02; rows 4) SELECT statement.object_id, statement.statement_number, statement.speaker_name, dayStatement.ordinal FROM sejm_transcript_day_statements dayStatement JOIN sejm_statements statement ON statement.object_id = dayStatement.statement_id WHERE dayStatement.day_id = 23038 AND dayStatement.day_revision_id = 22731 AND dayStatement.ordinal BETWEEN 70 AND 74 AND statement.object_id <> 23111 ORDER BY dayStatement.ordinal

5. (1.4ms; exec 1.39 + fetch 0.01; rows 1) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.object_id AND version.sequence_no = (SELECT MAX(latest.sequence_no) FROM document_versions latest WHERE latest.document_id = document.object_id) JOIN document_version_artifacts binding ON binding.version_id = version.object_id AND binding.role = 'html' AND binding.current_selector_sha IS NOT NULL WHERE document.owner_object_id = 23038 AND document.document_kind = 'statement_transcript' AND document.source_document_key = CONCAT('sejm:statement:', 70) LIMIT 1

6. (1.24ms; exec 1.23 + fetch 0.01; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extraction.run_id WHERE extraction.source_artifact_id = 25408 AND run.state = 'completed' ORDER BY CASE extraction.quality_state WHEN 'success' THEN 0 WHEN 'unreadable' THEN 1 ELSE 2 END, run.finished_at DESC, extraction.id DESC LIMIT 1

7. (0.94ms; exec 0.92 + fetch 0.01; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6759 ORDER BY ordinal

8. (1.67ms; exec 1.66 + fetch 0.01; rows 1) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.object_id AND version.sequence_no = (SELECT MAX(latest.sequence_no) FROM document_versions latest WHERE latest.document_id = document.object_id) JOIN document_version_artifacts binding ON binding.version_id = version.object_id AND binding.role = 'html' AND binding.current_selector_sha IS NOT NULL WHERE document.owner_object_id = 23038 AND document.document_kind = 'statement_transcript' AND document.source_document_key = CONCAT('sejm:statement:', 71) LIMIT 1

9. (1.59ms; exec 1.57 + fetch 0.02; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extraction.run_id WHERE extraction.source_artifact_id = 25409 AND run.state = 'completed' ORDER BY CASE extraction.quality_state WHEN 'success' THEN 0 WHEN 'unreadable' THEN 1 ELSE 2 END, run.finished_at DESC, extraction.id DESC LIMIT 1

10. (1.03ms; exec 1.01 + fetch 0.01; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6760 ORDER BY ordinal

11. (1.29ms; exec 1.28 + fetch 0.01; rows 1) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.object_id AND version.sequence_no = (SELECT MAX(latest.sequence_no) FROM document_versions latest WHERE latest.document_id = document.object_id) JOIN document_version_artifacts binding ON binding.version_id = version.object_id AND binding.role = 'html' AND binding.current_selector_sha IS NOT NULL WHERE document.owner_object_id = 23038 AND document.document_kind = 'statement_transcript' AND document.source_document_key = CONCAT('sejm:statement:', 73) LIMIT 1

12. (1.4ms; exec 1.39 + fetch 0.01; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extraction.run_id WHERE extraction.source_artifact_id = 25411 AND run.state = 'completed' ORDER BY CASE extraction.quality_state WHEN 'success' THEN 0 WHEN 'unreadable' THEN 1 ELSE 2 END, run.finished_at DESC, extraction.id DESC LIMIT 1

13. (1.32ms; exec 1.3 + fetch 0.02; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6762 ORDER BY ordinal

14. (1.73ms; exec 1.72 + fetch 0.02; rows 1) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.object_id AND version.sequence_no = (SELECT MAX(latest.sequence_no) FROM document_versions latest WHERE latest.document_id = document.object_id) JOIN document_version_artifacts binding ON binding.version_id = version.object_id AND binding.role = 'html' AND binding.current_selector_sha IS NOT NULL WHERE document.owner_object_id = 23038 AND document.document_kind = 'statement_transcript' AND document.source_document_key = CONCAT('sejm:statement:', 74) LIMIT 1

15. (1.2ms; exec 1.18 + fetch 0.02; rows 1) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extraction.run_id WHERE extraction.source_artifact_id = 25417 AND run.state = 'completed' ORDER BY CASE extraction.quality_state WHEN 'success' THEN 0 WHEN 'unreadable' THEN 1 ELSE 2 END, run.finished_at DESC, extraction.id DESC LIMIT 1

16. (0.96ms; exec 0.94 + fetch 0.01; rows 1) SELECT source_text FROM text_segments WHERE extraction_id = 6763 ORDER BY ordinal

17. (11.05ms; exec 10.94 + fetch 0.11; rows 17) SELECT individual.raw_club, individual.evidence_id, f.requested_url FROM sejm_individual_votes individual JOIN sejm_votes vote ON vote.object_id = individual.vote_id AND vote.current_revision_id = individual.vote_revision_id JOIN object_revisions revision ON revision.id = vote.current_revision_id JOIN evidence e ON e.id = individual.evidence_id JOIN fetches f ON f.id = e.fetch_id WHERE vote.term = 10 AND vote.sitting_number = 60 AND individual.mp_number = 300 AND LEFT(JSON_VALUE(revision.snapshot, '$.date'), 10) = '2026-06-19' AND individual.raw_club IS NOT NULL AND individual.raw_club <> '' ORDER BY vote.voting_number DESC

11.05ms SELECT individual.raw_club, individual.evidence_id, f.requested_url FROM sejm_individual_votes indiv…

4.14ms SELECT s.object_id AS statement_id, s.statement_number, s.speaker_name, s.source_member_id, mp.objec…

1.73ms SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.documen…

11.05ms SELECT individual.raw_club, individual.evidence_id, f.requested_url FROM sejm_individual_votes individual JOIN sejm_votes vote ON vote.object_id = individual.vote_id AND vote.current_revision_id = individual.vote_revision_id JOIN object_revisions revision ON revision.id = vote.current_revision_id JOIN evidence e ON e.id = individual.evidence_id JOIN fetches f ON f.id = e.fetch_id WHERE vote.term = 10 AND vote.sitting_number = 60 AND individual.mp_number = 300 AND LEFT(JSON_VALUE(revision.snapshot, '$.date'), 10) = '2026-06-19' AND individual.raw_club IS NOT NULL AND individual.raw_club <> '' ORDER BY vote.voting_number DESC

4.14ms SELECT s.object_id AS statement_id, s.statement_number, s.speaker_name, s.source_member_id, mp.object_id AS member_id, day.object_id AS day_id, day.term, day.proceeding_number, day.source_date, day.current_revision_id AS day_revision_id, dayStatement.ordinal, dayEvidence.id AS list_evidence_id, dayEvidence.selector_type AS list_selector_type, dayEvidence.selector AS list_selector, dayFetch.id AS list_fetch_id, dayFetch.requested_url AS list_source_url, dayArtifact.sha256 AS list_sha256, binding.artifact_id, binding.evidence_id AS transcript_evidence_id, transcriptEvidence.selector_type AS transcript_selector_type, transcriptEvidence.selector AS transcript_selector, transcriptFetch.id AS transcript_fetch_id, transcriptFetch.requested_url AS transcript_source_url, artifact.sha256 AS transcript_sha256, artifact.detected_mime, artifact.byte_size FROM sejm_statements s JOIN sejm_transcript_days day ON day.object_id = s.transcript_day_id LEFT JOIN sejm_mp_identities mp ON mp.term = day.term AND mp.mp_number = s.source_member_id LEFT JOIN sejm_transcript_day_statements dayStatement ON dayStatement.day_id = day.object_id AND dayStatement.day_revision_id = day.current_revision_id AND dayStatement.statement_id = s.object_id LEFT JOIN evidence dayEvidence ON dayEvidence.id = dayStatement.evidence_id LEFT JOIN fetches dayFetch ON dayFetch.id = dayEvidence.fetch_id LEFT JOIN artifacts dayArtifact ON dayArtifact.id = dayEvidence.artifact_id LEFT JOIN documents document ON document.owner_object_id = day.object_id AND document.document_kind = 'statement_transcript' AND document.source_document_key = CONCAT('sejm:statement:', s.statement_number) LEFT JOIN document_versions version ON version.document_id = document.object_id AND version.sequence_no = (SELECT MAX(latest.sequence_no) FROM document_versions latest WHERE latest.document_id = document.object_id) LEFT JOIN document_version_artifacts binding ON binding.version_id = version.object_id AND binding.role = 'html' AND binding.current_selector_sha IS NOT NULL LEFT JOIN evidence transcriptEvidence ON transcriptEvidence.id = binding.evidence_id LEFT JOIN fetches transcriptFetch ON transcriptFetch.id = transcriptEvidence.fetch_id LEFT JOIN artifacts artifact ON artifact.id = binding.artifact_id WHERE s.object_id = 23111 LIMIT 1

1.73ms SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.object_id AND version.sequence_no = (SELECT MAX(latest.sequence_no) FROM document_versions latest WHERE latest.document_id = document.object_id) JOIN document_version_artifacts binding ON binding.version_id = version.object_id AND binding.role = 'html' AND binding.current_selector_sha IS NOT NULL WHERE document.owner_object_id = 23038 AND document.document_kind = 'statement_transcript' AND document.source_document_key = CONCAT('sejm:statement:', 74) LIMIT 1

5× (6.94ms) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing…

5× (5.58ms) SELECT source_text FROM text_segments WHERE extraction_id = ? ORDER BY ordinal

4× (6.09ms) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON versi…

5× (6.94ms) SELECT extraction.id, extraction.quality_state FROM extractions extraction JOIN processing_runs run ON run.id = extraction.run_id WHERE extraction.source_artifact_id = ? AND run.state = ? ORDER BY CASE extraction.quality_state WHEN ? THEN ? WHEN ? THEN ? ELSE ? END, run.finished_at DESC, extraction.id DESC LIMIT ?

5× (5.58ms) SELECT source_text FROM text_segments WHERE extraction_id = ? ORDER BY ordinal

4× (6.09ms) SELECT binding.artifact_id FROM documents document JOIN document_versions version ON version.document_id = document.object_id AND version.sequence_no = (SELECT MAX(latest.sequence_no) FROM document_versions latest WHERE latest.document_id = document.object_id) JOIN document_version_artifacts binding ON binding.version_id = version.object_id AND binding.role = ? AND binding.current_selector_sha IS NOT NULL WHERE document.owner_object_id = ? AND document.document_kind = ? AND document.source_document_key = CONCAT(?, ?) LIMIT ?

(0.46ms) /app/templates/speeches/show.php

/app/public/index.php

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/app/src/Http/WatchRoutes.php

/app/src/Http/SpeechController.php

/app/src/Overview/SpeechReadModel.php

/app/src/Text/TextSearch.php

/app/templates/layout.php