Czech President Havel Pledges Own Money to Aid Health Care System : Eastern Europe: The writer donated $130,000 in royalties and prizes to the Czech and Slovak regional health ministries to help them buy medicines they cannot afford.

PRAGUE —  President Vaclav Havel and his wife, Olga, are trying to help stave off the collapse of Czechoslovakia’s state health system.

Havel recently donated $130,000 of his money--foreign royalties from plays and prizes he has collected over the last year--to the Czech and Slovak regional health ministries to help them buy medicines they cannot afford.

His wife runs a charity, the Goodwill Foundation, which accepts gifts from abroad of much-needed medical equipment and drugs intended for use in the treatment of children.

Czechoslovakia is beginning a two-year radical reform of health care, giving patients the right to choose their own doctors and introducing paid health insurance.

It will replace a corrupt and demoralized--but free--system left over by the country’s former Communist government.

However, medical facilities are coming under increasing strain. The health service faces acute financial problems and a chronic lack of some drugs. Many medicines are too expensive to be bought abroad since the devaluation of the country’s currency last year.

Many low-paid doctors managed under the Communists to augment their incomes by black-market work. They would like to bring this into the open by having private practices.

“People can’t afford paying health care before health insurance is introduced” in 1992, Czech regional health minister Martin Bojar said in an interview.

Bojar recently said prescription charges will probably go up from a token 3.5 cents to 18 cents, hospital care will be charged at $1.07 a day and abortions, currently free and available almost on demand, will cost $110--just slightly less than the average monthly wage.

Bojar, a 44-year-old highly respected psychiatrist and neurologist, was appointed health minister for the Czech republic last June.

Energetic and much in demand, he will even give interviews in his car en route to answer questions in the Czech Parliament rather than cancel a chance to express his views.

Bojar says Czechoslovakia’s state-run health service is not quite as devastated as Romania’s, for example. But charity is encouraged and foreign help is welcomed to prop up the tottering system.

The parents of a 4-year-old child, Patrik Polansky, recently appealed through the media for money that could buy him a liver transplant, an operation that cannot be performed in Czechoslovakia.

Bojar said the end of the state monopoly on medicine, free choice of one’s doctor and allowing the partly private practice of doctors should stimulate health care.

He cites the Canadian and Dutch health systems as models for the reforms he is trying to implement. By 1992, medicine will be financed jointly by insurance, local authorities and the state.

But there is much to be done in the meantime. Czechoslovakia has one of the highest numbers of medical personnel per capita in Europe, but hospitals are inefficient.

Nurses often have to perform tasks carried out by unskilled staff members in other countries, and doctors’ duties include some that in the West are considered nurses’ jobs.

Bojar’s budget this year, to provide comprehensive health care for about 10 million people, is $1 billion, 8% more than in 1990.

But officials in his ministry estimate that about half the total amount will be needed to compensate for the higher cost of drugs and equipment following the freeing of price controls that came into effect at the beginning of this year.

The budget will have to be revised every three months so that funds can be directed to the most urgent needs, they say.