2013-12-11 20:54:24
EOPYY, two years after launch, it proves not to be the successor of the pension funds in the country, but a universal contractor for insurance funds, as these funds have outsourced to EOPYY the health care contracts to cover their beneficiaries. Two years later, it turns out that the Medical Associations of the country were right screaming out that EOPYY is a “stillborn” case and were unjustly accused by the previous political leadership that their voices were based on self-interested purposes.
It is now clear that each insured individual has retained his/her booklet as before and that the invoices are not stamped up with the logo "EOPYY" but IKA, OAEE, OGA, etc, as previously.
This project of healthcare coverage was undertaken firstly to reduce, effectively and quickly, consumption within the health sector and secondly to give the appropriate flexibility and efficiency to the central administrators to delineate planning and budget that should be applied each time in the field, according to government’s policy and troika’s prescription.
Unfortunately, the Greek insured population presents an obvious heterogeneity and a large economic gap exists in the field of social security contributions, with the remarkable example of the wide gap between contributions of OGA (600-1600 euros per year with 7 categories) compared with those of other funds mainly OAEE and ETAA (3000 -3500 euros per year).
Despite the large differences in insurance payments between the Greek funds, EOPYY adopted a uniform national policy based on two fundamental errors:
a) It equalized the benefits in a single pricelist for all members, irrespective of the amount of contributions that everyone pays.
b) It allowed everybody to use the primary or secondary medical structures, as many times as he/she wanted to, thus consuming the small annual budget within the first four months of each year and leaving doctors unpaid.
Alongside, EOPYY established the contribution of the patient for medical investigations at the low level of 15%, using a populist phraseology and passing messages to the voters for a free public health. This level of participation will not prevent over-consumption, but on the contrary will detriment the general account. It is questionable, why well known professorial brains in Public Health and Finance, from well established University Institutions, haven’t openly disagreed with this economically devastating choice of EOPYY. On the contrary to common sense, EOPYY turned to the physicians of the country at all levels and accused them (and still does so) that they all getting rich doing their job (!!) and decided to confine them, as the budget is running out of money, due to their wasteful practice.
Therefore, EOPYY legislated limits to the clinicians for up to 200 patient visits per month. This incredible policy forced the physicians to divide patients into beneficiaries and non-beneficiaries for a free visit, unless the total monthly visits were less than 200 visits, which, in any case, is not the everyday practice throughout the year. On the other hand, EOPYY imposed on laboratories a 50% reimbursement of the calculated and invoiced receipts (clawback, rebate), as a penalty to the labs which enjoy trust and preference of the patients and present a high turnover, promoting a rather soviet model of enterprising, sending to the trash-bin the motto “we belong to the west”, which had been the key element for entering European Union.
Nevertheless, medical thinking and medical practice is unaffected by the economic realities and choices of each Minister of Health indeed. Politicians, who are not physicians trying to cope with the "sport" of healthcare strategy, need to acknowledge that medical textbooks from all over the world do not refer how to diagnose and cure a patient based on the money in his/her pocket, but they rather teach how to cure the patient early and efficiently or to promote a better life quality, without mentioning money.
Now is the time to change the system and to transform it from physician-oriented to patient-oriented, i.e. we must focus on the patient. Now is the time to decide the amount that may be consumed by each insured person in Greece and to create individual accounts for each one patient, leaving the medical staff out of this economic conflict to do their job. The Greek State must confess the hint that does not want to leak out all these years: that it can’t afford to pay more than 450 - 500 euros per year on average for each citizen, in order to cover medicines and medical care including hospitalizations.
We must therefore create individual accounts in www.e-syntagografisi.gr, where everybody’s data exist, with a personal consumption limit, referred to each one separately. We must take into account several parameters like: a) the age, b) the existence of chronic forms of disease, c) the working status and d) the premiums paid, in order to determine with social justice the number of the insured visits and transactions per year for medical care with free choice of the physician. Patients should participate in the expenses for laboratory examinations at a proper level in order to prevent over-consumption.
Bearing in mind the geomorphological characteristics of Greece, we clearly need rural doctors and the Health Centers of NHS in service, since in some areas it’s hard to find even unskilled doctors. The structures of EOPYY (former IKA) must not close especially in those areas where no NHS structure exists and vice versa. Both Health Centers and polyclinics of the EOPYY-IKA essentially are competing against one another and therefore must be reevaluated comparing operating costs in relation to medical output. However cuts in EOPYY should start from housing rents and not from sending away doctors for the sake of the economy, because the Greek State is obliged to provide free Primary Health care service, as the contributions for insurance are maintained mandatory. If the Greek government does not want to provide free Primary Health service then the insurance contributions should be reduced significantly. Consequently, the private medical sector must be given the opportunity to offer coverage to the population via private Primary Health Care networks.
Medicine is evolving and will not stop adopting newer drugs, techniques and methodologies which will probably be more and more expensive, leading Governments in despair, with false estimates about the money they need to spent for healthcare reform each year and pressing the patients’ budget, who neither can afford to pay the bill. Citizens in Greece want the truth. They want to choose freely their doctor and they want EOPYY to proceed in a collective contract with the National Medical Association and so with all the doctors in the country, for a general cost plan, covering medical visits, operations and examinations, corresponding to the current economic situation, using a proper participation of the insured and setting limitations to the insured, who will then interact with their doctor, and would effectively limit consumption of healthcare resources.
We must not forget that the entrance door of the clinic is opened by the patients and not by the doctors. EOPYY must drink the “water” of social justice first in order to find the way to the “treasure”.
K Panagiotopoulos, MD
Cardiologist.
President of Argolis Medical Association
medispin
It is now clear that each insured individual has retained his/her booklet as before and that the invoices are not stamped up with the logo "EOPYY" but IKA, OAEE, OGA, etc, as previously.
This project of healthcare coverage was undertaken firstly to reduce, effectively and quickly, consumption within the health sector and secondly to give the appropriate flexibility and efficiency to the central administrators to delineate planning and budget that should be applied each time in the field, according to government’s policy and troika’s prescription.
Unfortunately, the Greek insured population presents an obvious heterogeneity and a large economic gap exists in the field of social security contributions, with the remarkable example of the wide gap between contributions of OGA (600-1600 euros per year with 7 categories) compared with those of other funds mainly OAEE and ETAA (3000 -3500 euros per year).
Despite the large differences in insurance payments between the Greek funds, EOPYY adopted a uniform national policy based on two fundamental errors:
a) It equalized the benefits in a single pricelist for all members, irrespective of the amount of contributions that everyone pays.
b) It allowed everybody to use the primary or secondary medical structures, as many times as he/she wanted to, thus consuming the small annual budget within the first four months of each year and leaving doctors unpaid.
Alongside, EOPYY established the contribution of the patient for medical investigations at the low level of 15%, using a populist phraseology and passing messages to the voters for a free public health. This level of participation will not prevent over-consumption, but on the contrary will detriment the general account. It is questionable, why well known professorial brains in Public Health and Finance, from well established University Institutions, haven’t openly disagreed with this economically devastating choice of EOPYY. On the contrary to common sense, EOPYY turned to the physicians of the country at all levels and accused them (and still does so) that they all getting rich doing their job (!!) and decided to confine them, as the budget is running out of money, due to their wasteful practice.
Therefore, EOPYY legislated limits to the clinicians for up to 200 patient visits per month. This incredible policy forced the physicians to divide patients into beneficiaries and non-beneficiaries for a free visit, unless the total monthly visits were less than 200 visits, which, in any case, is not the everyday practice throughout the year. On the other hand, EOPYY imposed on laboratories a 50% reimbursement of the calculated and invoiced receipts (clawback, rebate), as a penalty to the labs which enjoy trust and preference of the patients and present a high turnover, promoting a rather soviet model of enterprising, sending to the trash-bin the motto “we belong to the west”, which had been the key element for entering European Union.
Nevertheless, medical thinking and medical practice is unaffected by the economic realities and choices of each Minister of Health indeed. Politicians, who are not physicians trying to cope with the "sport" of healthcare strategy, need to acknowledge that medical textbooks from all over the world do not refer how to diagnose and cure a patient based on the money in his/her pocket, but they rather teach how to cure the patient early and efficiently or to promote a better life quality, without mentioning money.
Now is the time to change the system and to transform it from physician-oriented to patient-oriented, i.e. we must focus on the patient. Now is the time to decide the amount that may be consumed by each insured person in Greece and to create individual accounts for each one patient, leaving the medical staff out of this economic conflict to do their job. The Greek State must confess the hint that does not want to leak out all these years: that it can’t afford to pay more than 450 - 500 euros per year on average for each citizen, in order to cover medicines and medical care including hospitalizations.
We must therefore create individual accounts in www.e-syntagografisi.gr, where everybody’s data exist, with a personal consumption limit, referred to each one separately. We must take into account several parameters like: a) the age, b) the existence of chronic forms of disease, c) the working status and d) the premiums paid, in order to determine with social justice the number of the insured visits and transactions per year for medical care with free choice of the physician. Patients should participate in the expenses for laboratory examinations at a proper level in order to prevent over-consumption.
Bearing in mind the geomorphological characteristics of Greece, we clearly need rural doctors and the Health Centers of NHS in service, since in some areas it’s hard to find even unskilled doctors. The structures of EOPYY (former IKA) must not close especially in those areas where no NHS structure exists and vice versa. Both Health Centers and polyclinics of the EOPYY-IKA essentially are competing against one another and therefore must be reevaluated comparing operating costs in relation to medical output. However cuts in EOPYY should start from housing rents and not from sending away doctors for the sake of the economy, because the Greek State is obliged to provide free Primary Health care service, as the contributions for insurance are maintained mandatory. If the Greek government does not want to provide free Primary Health service then the insurance contributions should be reduced significantly. Consequently, the private medical sector must be given the opportunity to offer coverage to the population via private Primary Health Care networks.
Medicine is evolving and will not stop adopting newer drugs, techniques and methodologies which will probably be more and more expensive, leading Governments in despair, with false estimates about the money they need to spent for healthcare reform each year and pressing the patients’ budget, who neither can afford to pay the bill. Citizens in Greece want the truth. They want to choose freely their doctor and they want EOPYY to proceed in a collective contract with the National Medical Association and so with all the doctors in the country, for a general cost plan, covering medical visits, operations and examinations, corresponding to the current economic situation, using a proper participation of the insured and setting limitations to the insured, who will then interact with their doctor, and would effectively limit consumption of healthcare resources.
We must not forget that the entrance door of the clinic is opened by the patients and not by the doctors. EOPYY must drink the “water” of social justice first in order to find the way to the “treasure”.
K Panagiotopoulos, MD
Cardiologist.
President of Argolis Medical Association
medispin
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