Romania ranks first in the European Union in terms of deaths from preventable and treatable causes, and this is because neither the state nor the citizens pay attention to prevention. Concretely, Romania allocates less than 4% of the budget for prevention, according to the latest Eurostat report.
2 out of 3 Romanians do not have preventive medical check-ups – Photo Shutterstock
We are in 4th place from the bottom of the ranking with only 30.5 euros per capita, surpassing only Poland, Slovakia and Bulgaria. In contrast, Austria leads the way, allocating 10.3% of its health budget to prevention, followed by Denmark with 8.9% and the Netherlands with 8.7%.
We finance “black holes”
“We, the Romanians, have always been in the last place, when it comes to the financing of prevention, but there are also other influencing factors: health education, but also the infrastructure of the system and the legislation that does not oblige either the insured, the insurer or the provider to provide preventive medical services. We need to talk about prevention in health and on other levels, it's about unhealthy food, lifestyle, the general infrastructure of the system, not only that related to health services“, explained Vasile Barbu, president of the National Association for Patient Protection, for “truth“.
Why don't we have enough funding for the prevention system? Because “we are also funding black holes at the same time. We do not have a management of preventive financial control, preventive control of the use of health resources, this is why the use of that unique national health social insurance fund, which is collected from the population, is given to the Insurance House in its entirety, indeed, but it is punctured by black holes of the health system, very large amounts, which greatly influence quality and financing“, adds the patient representative.
When we manage to have a significantly larger health budget, we will be able to prioritize preventive measures even more, says doctor Gindrovel Dumitra, vice president of the National Society of Family Medicine. “Portugal seems to me to be a great example, many of the prevention programs, including primary prevention through vaccination, but also secondary prevention through screening, that is reaching coverages between 80% and 90%, maybe even over 90% if we talk about vaccination, thing which can only be an investment in health“, he explained.
We don't like going to the preventive doctor
But 2 out of 3 Romanians do not have their preventive medical check-ups, the STADA report for 2023 also shows, and one of the main reasons is the high cost of the tests, according to the opinion expressed by approximately 42% of the study participants.
“I would like the patient to be proactive and come to meet the doctors, to come to the preventive doctor for consultation – this means changing the health behavior“, stated the president of CNAS, Valeria Herdea, in February.
Do Romanians go to an annual medical consultation, as Valeria Herdea recently urged? “Definitely not“, says doctor Gindrovel Dumitra.
“The first 5-year cervical cancer screening program that happened between 2012 and 2017 had a cervical cancer prevention coverage of only 8%. So it is clear that from 8% to 80% and 90% is a very big difference that we will have to cover through concerted efforts. My opinion is that the indicators that we meet in Western countries will never be reached“, explained the doctor.
“There is a mistaken perception among the population that a prophylactic examination to prevent all problems is done by investigation, possibly a CT, from head to toe, as many patients say, or all analyses. No, a prophylactic examination involves primarily a discussion, a counseling with your family doctor. Then, the family doctor will identify a series of risk factors that he will be aware of regarding the evolution of tumor formations or diseases. Alcohol consumption, an unbalanced diet and, of course, a sedentary regime, poor physical activity, all these contribute to mortality from cardiovascular diseases and not only. And they can be prevented not only by analysis, but by changing behavior and lifestyle“, Gindrovel Dumitra explains to us.
Cancer screening programs in Romania
We have disease screening programs”which we hear more and more around us and which can be prevented“, emphasizes Dr. Gindrovel Dumitra.
Screening for cervical cancer can be done by two methods: anti-HPV testing and the Babeș Pap test, which benefits women between the ages of 25 and 64.
Breast cancer screening is for women between the ages of 45 and 70 and involves a mammogram every two years.
Colorectal cancer is detected by testing with the HEMOCULT test, that is, the identification of bleeding invisible to the naked eye from the digestive tract, the age group is 57-65 years.
“Also discussed is prostate cancer, which benefits from PSA testing. An analysis that can be performed on men who are over 50 years old”says the doctor.
