A good measure, poorly implemented. The doctors in Iași are expecting a record number of patients, after the regulatory act approved by the government entered into force, by which uninsured patients with oncological diseases benefit from July 1 of free prevention, diagnosis and treatment services, as well as insured persons, according to a normative act approved by the government. And patient representatives point out that the lack of funds, family doctors in the red and more will affect the implementation of the new measures.
Over 2 million Romanians do not have health insurance – Photo Archive
About 2 million Romanians do not have health insurance, one of the highest percentages in the European Union. This is also the reason why oncologists in Iasi anticipate an influx of patients in hospitals and family doctors’ offices with the implementation of the new measures,
Of the 130 medical service packages newly introduced for day hospitalization, 120 are intended for the diagnosis of oncological conditions and are granted to both insured and uninsured persons, based on a ticket issued by the family doctor or the outpatient specialist.
“The uninsured person can go to the family doctor in a designated area, sign up on the list and receive a referral ticket for clinical consultations or paraclinical investigations. The family doctor reports the service to the Insurance House, separately for the insured person and for the uninsured person. In the same way, the clinical, paraclinical or hospital medical units are obliged to consult the respective patients, to provide medical services, to report these services to the Insurance House“, explained the manager of the Regional Institute of Oncology (IRO) Iasi, Mirela Grosu, quoted by Agerpres.
“The legislator wanted the implementation of the National Plan to Combat and Control Cancer, to reduce the incidence of this disease, to reduce the detection period to benefit from medical treatment“, added the manager.
According to doctors, the investigation period for cancer detection should be no more than 28 working days.
“It is a challenge for us and for all medical units to meet this deadline, because we all know that the requests are more than the services we can provide. It will be necessary to rethink the offices, the consultation programs, the endowments with medical equipment”the manager specified.
“They will be overwhelmed”
“That’s right, they’re right. Because for nothing, in a populist and electoral way, we do these things without actually funding. And the goal is for every uninsured patient to be detected faster, to be detected early, because then the costs go down for treatments. It is also a benefit for the patient who has a better chance of survival. But the moment you said that, everyone who suspected cancer would overwhelm the Institute, for sure. But let’s think further. Does everyone have suspected cancer? Who decides that? Family history, genetics, work environment? I’m a bit confused about this decision. I admit it’s very good, because anyway all subsequent patients have the right to free treatments, that it’s radio, that it’s chemo, that it’s oncology surgery. Because I’ve seen cases where people sold their homes, everything they had, to give themselves a chance at life. But what are we doing here? Where does the money come from? When there is currently a major financial crisis, there are no medicines in the hospitals, the system was not financed and there is a valley of complaint.“, commented for “The Truth” Cezar Irimia, President of the Federation of Associations of Cancer Patients.
Concert, because the health system is facing both funding problems and a lack of doctors, the project, a good one in essence, can upset the activity in the oncology wards in the country.
“The project is sublime, but it is completely lacking. And I’m glad that the people from Iasi took the bull by the horns and told the truth. Family doctors – NO, funding – NO, they will be overwhelmed, because the system is substandard anyway. If an institute did this work, what will happen to the county hospitals that have oncology departments?“, adds the patient representative.
Then, the measure also represents an additional pressure for family doctors, considering that we have a shortage of 1529 family doctors.
“So a number that scares me plus how many are retiring. It’s all divide and conquer, muddy the waters so that only you catch the big fish and the rest of the fish look at the muddy water, that’s what’s going on in health right now. So much irresponsibility… I’ve been on this street since 2001. I have not seen such irresponsibility on the part of the decision-makers.“, emphasizes Cezar Irimia.
Meanwhile, more than 10,000 doses of HPV vaccines, which can prevent cervical cancer, risk expiring without being used. Annually, nearly 3,400 women are diagnosed and 1,805 die from this disease.
“Have you seen any sustained campaign by the Ministry of Health in this regard? Have you seen that the doctors went to the countryside to convince the world or to the urban? So, “we gave you, if you didn’t say goodbye.”. Where is health education in this regard? In 2008 we started with Australia to make a fuss and recommend vaccination of children, Australia and Canada started with us, they eradicated cervical cancer. We are still in the first place in terms of mortality. I no longer have any faith in these scoundrels who underfinance the system, they scurry to make their election campaign and we really don’t choose anything in the end. When you only come with populist proposals, in the conditions in which you did not extend the cost-volume contracts, regarding access to treatments, that the contracts expired, they did not renew them because they have no money. There are drugs that have passed the ANM to be introduced free of charge in patients’ treatments. They don’t have money for those either“, concludes the President of the Federation of Associations of Cancer Patients.
Effects on society
The government introduced the changes to speed up cancer diagnosis and increase survival. This is because oncological diseases rank second in the list of major causes of mortality in Romania, with 46,370 deaths registered in 2023, representing 19.1% of all deaths.
Dr. Vasile Cepoi from IRO Iași explained that the measures are necessary because of the additional costs that the disease imposes on the health system.
“Oncological disease does not take into account the fact that you are or are not insured and its costs are the same for some as for others. Even more so if you are uninsured and you are not identified in time, the costs will be higher, because the presentation to the doctor for treatment will be late and with worse results”said Dr. Vasile Cepoi, doctor at IRO Iaşi and former director of the Public Health Directorate (DSP) Iaşi.
The doctor believes that the success of implementing these measures largely depends on family doctors.
“It is necessary to encourage family doctors to respond to these requirements for timely identification of oncological patients. In the case of uninsured patients, they must register on the list of a family doctor in the surrounding area, who must also evaluate them from the point of view of the risk of oncological disease and chronic disease“, said Dr. Vasile Cepoi.
We remind you that, from July 1, uninsured people have access to essential services for the early detection and diagnosis of cancer, including the confirmation of the diagnosis of an oncological condition in ambulatory and hospital medical care. These services are offered in addition to the already existing minimum package of services. From 2022, people without health insurance benefit from free primary healthcare through family doctors.
