In series of media appearances in early 2013, Head of the National Health Insurance Fund Dr. Plamen Tsekov tried to convince everybody that the 2013budget of the institution led by him is stable and well balanced. It will cover all medically necessary activities and medications. It’s true that the 2.7 billion levs, which fund will have to operate hospitals, GPs, dentists, suppliers and manufacturers of drugs, is the largest amount that has been available to it in the past 20 years. However, at the beginning of the year people found out that some activities and pathways are too underfinanced, others are covered just to a level, where quality of treatment will necessarily have to be compromised, while third ones – that had been transferred from the health ministry to the fund will still show more problems in the future.
It is clear that there is no government that can inject additional 3-4 billion levs in healthcare and introduce the coveted diagnostic-related groups as a form of financing system. The proven distortions of current clinical pathways should at least acquire a more realistic value that pretty much covers the expectations of doctors and patients. The health contract, however, has been broken for the first time in many years when the Medical Association refused to sign the National Framework Agreement so things went completely out of control. This act was used too cunningly by the NHIF, which administratively approved prices, so that it can have a balanced budget. But the balance seems to be made entirely in the interest of officials who, instead of protecting the interests of the insured, are rather neglecting the needs of most of them.
Patients with rare diseases will continue to ask the state or donors for significant sums to buy expensive medications or undergo the needed therapy for their rehabilitation. Recently the institution promised to cover the expensive treatment
of kids suffering from diseases such as congenital bone fragility and adolescent rheumatoid arthritis. Especially touching was the case with Stiliyan Sashev suffering from severe nephrotic syndrome diagnosed in which the limbs and lungs swell and breathing becomes difficult because excessive production of protein. The boy needs 200 levs a month for drugs that his family cannot pay. Absurdly enough, transplant patients had to send him from their own medication, while the state was just observing.
There is no economic logic for costly cancer treating equipment to collect dust in warehouses of hospitals because they have no financial interest to use it. Patients already sent a complaint to the Ombudsman Konstantin Penchev and the Commission for Protection against Discrimination, which pointed out that the health ministry and the Fund infringe the rights of approximately 250 patients with pituitary tumors to receive timely and adequate treatment and thus condemn them to disability. Vanya Dobreva, president of the association Pituitary indicates that the cost of high-tech radiotherapy in the relevant pathways are only partially covered. One of the paths covers 1400 levs, and its value is at least 4000 levs while
radio surgery does not exist at all in the list of covered operations of the Fund.
The BANKER
