The draft bills for the implementation of the General Health Plan have taken shape and its long course reaches the stage of dialogue, discussion and approval by Parliament. The Minister of Health Filippos Patsalis explains that the goal of all should be the implementation of a system capable of producing positive health results, ie to improve the health of the population.
Points out that the General Health System is a project that has been discussed for decades and is a memorandum obligation, and notes that everyone from the role they serve and / or represent, whether they are parties, health professionals, or organized patient groups and organized social groups in general, have been ardent supporters for years of the implementation of the GESS.
The Minister of Health emphasizes that the draft provides for the implementation of the GESS through the Health Insurance Organization. It refers to the possibility of the competent Authority to consider measures for the continuous modernization and upgrade of the GESS, including its evolution into a mixed system, meaning that additional benefits for the citizens arise and the fundamental principles of the system continue to be fulfilled. In the event of a political decision to transform the system into a mixed system with the participation of more than one insurance partner, the law should be amended.
The drafts clearly state that the Health policy at GESS is determined by the competent Authority (Ministry of Health) and includes the definition of the health care provided by GESS.
The health care provided by GESS includes the categories of services defined below, as they will be determined by decrees of the Minister of Health, as well as any other service that may be determined by decree of the Minister, each year:
>> Health care by personal physicians and specialist physicians, including inpatient care.
>> Imaging diagnostic tests, clinical laboratory tests, specialized biomedical laboratory tests.
>> Pharmaceutical care and administration of medical devices.
>> Health care from nurses and midwives, as well as from other health professionals.
>> Palliative health care and medical rehabilitation, including the supply, maintenance and renewal of orthopedic and orthopedic items and artificial limbs.
>> Dental health care to specific groups of beneficiaries.
>> Home visits from health care providers.
>> Ambulance transport and health care in case of accident and emergency.
>> In addition, it may cover cases of psychiatric hospitalization and cases of compulsory psychiatric hospitalization.
The Minister explains that:
• The major social inequalities that exist in health must be corrected through a system that will guarantee universal access to all citizens of this country in health care services, upgraded in quality and quantity, without discrimination and for the rest of their lives. At the same time, the financial viability of the system should be preserved through the contributions paid on the basis of the income of each beneficiary.
• The financing of the system, according to the Minister, will be done through contributions from employees, employers, self-employed, retirees, income earners, officials and the state.
• The amount of contributions from the various categories of beneficiaries, as well as the procedures for collection, payment and withholding of contributions will be regulated by regulations, which will be approved by the Council of Ministers and the Parliament.
• Responsible for the collection of contributions will be the director of Social Security Services of the Ministry of Labor and the Tax Officer.
The "Health Insurance Fund" that will be established will be responsible for the collection of contributions for the GESS. The contributions collected by the competent departments of the Government are deposited by the Permanent Fund of the Republic in the Health Insurance Fund and are used exclusively to cover the needs of the GESS.
Mr. Patsalis explains that on the basis of an annual budget that will be prepared by the Health Insurance Organization and approved by the Council of Ministers and the Parliament, funding is paid by the Health Insurance Fund to the OAY in four installments per year. The funding provided to OAY covers the cost of the services provided by GESS, as well as the operating costs of OAY. The money of the Health Insurance Fund cannot be borrowed from the state or anywhere else, for any purpose. Any reserves may not be invested through the Fixed Fund of the Republic.
The financial management of the Health Insurance Fund will be done by a nine-member Board of Directors with a term of 30 months, which consists of the three parties that contribute to the Fund (state, employees and employers), as follows: The president representing the Government. The vice-president representing the Government, the general directors of the Ministry of Health and the Ministry of Finance, the director of the GESS of the Ministry of Health, two representatives of the employers 'organizations and two representatives of the workers' organizations.
The persons appointed as members of the Board of Directors of the fund should be of the highest moral and professional prestige, should not be members of parliamentary and non-parliamentary parties and / or groups and have high university qualifications and experience in one or more of the fields of provision financial or accounting services and business administration.
The draft bills that have been prepared clearly stipulate that the money of the Health Insurance Fund will be used exclusively to cover the needs of GESS. Provisions of the bill prohibit the lending of Health Insurance Fund money to the state or anywhere else for any purpose. The Board of Directors of the Fund will pay the annual approved budgeted amount from the fund to the Health Insurance Organization in four installments per year. The assets of the fund, in order to maximize its reserves and taking into account the security, liquidity and return on investment, can be invested after a decision of the Board of Directors of the fund and with the approval of the Ministers of Health and Finance.
The supervision and control of the Health Insurance Fund will be exercised by the Auditor General of the Republic, the Minister of Health points out and notes that the General Accountant of the Republic will direct and supervise the accounting work of the fund. An actuary, appointed by the Fund's Board of Directors, will review and evaluate the fund's financial position on a yearly basis. The Board of Directors of the fund will be invited every year to conduct a study on the financial management of the fund by an international specialized organization.
The role of OAY based on the drafts will be focused on the implementation of the GESS by ensuring access and provision to the beneficiaries of health care services. In this context, OAY will contract with health care providers, and as otherwise provided by law, on the basis of the budget allocated to it by the Board of Directors of the Health Insurance Fund. OAV responsibilities also include monitoring and monitoring the terms and conditions of contracts and the performance of health care providers.
The drafts provide for the establishment of an Advisory Committee, the members of which represent the interests of the various categories of contributors and beneficiaries, in order to advise and inform the competent authority on any issues related to the rights and obligations of contributors and beneficiaries.
The Advisory Committee will consist of the current Director General of the Ministry of Health, who acts as President, the Director General of the Ministry of Health, who acts as Vice President, 4 technocrats of the Ministry of Health, appointed by the Deputy Minister of Health. trade unions, 3 representatives of employers' organizations and one representative of the self-employed and patients.
Categorization of doctors with the new system
For the provision of health care services by doctors within the GESS, doctors are divided, based on the drafts, into the following categories:
(a) Personal physicians, for the provision of exclusively primary health care services to outpatients
(b) Specialist physicians, for the provision of secondary health care services to outpatients and to patients admitted to hospitals.
>> PERSONAL DOCTORS: The institution of the personal physician is adopted as a gateway to the system and as a basic tool to contain the total costs of the system. The personal physician and other health care providers will be referred through the personal physician.
Doctors who meet the requirements of one of the following categories will have the right to register as personal physicians:
Doctors specializing in General Medicine, or
Physicians specializing in Pathology, or
Doctors specializing in Pediatrics for children, or
- doctors who, until the entry into force of this law, hold special training in General Medicine recognized by the Medical Council of Cyprus under the Law on the Registration of Physicians, or
- Doctors who, until the entry into force of this law, hold a certificate certifying the right to practice the activities of a general practitioner within the national social security system in accordance with Regulation 8F, paragraph 2, of the Doctors (Special Qualifications) Regulations of 2003 until 2009, or doctors who, until the entry into force of this law, hold a recognized certificate issued by the competent authorities of other Member States to their nationals, granting them the right to practice as a General Practitioner within the national social system. insurance in accordance with Regulation 8F, paragraph 3, of the Doctors (Special Qualifications) Regulations of 2003 to 2014,
-Doctors who do not fall under the provisions of the above paragraphs will have the right to contract with OAY as personal physicians, after attending a special training program which will be prepared by the Ministry of Health, in collaboration with PIS and OAY, and will completed by the entry into force of the Law. Specialists and pediatricians who have chosen to register as personal physicians are entitled to provide secondary health care services as specialist physicians within the GESS for the patients who will be registered in their list.
For the number of beneficiaries, which is registered in the list of personal physicians, there is no limit, while for the provision of primary medical care will be allowed the establishment and operation of cooperatives, with conditions that will be regulated by Regulations.
Salaries and hospitalizations will be determined after consultation
The drafts provide that the amount of remuneration for professional health care services will be determined by Regulations after consultation of the Ministry of Health with the OAY and the competent professional associations, associations or bodies, as the case may be. Regulations will also determine the compensation procedures of the hospitals that contract with the OAY. Hospitals are reimbursed based on Diagnosis Related Groups or other methods. The amount of the compensation of the hospitals is determined by Regulations by the Minister of Health after consultation with the OAY, PASIN and the competent professional associations, associations or bodies.
With regard to health care services which are not offered in Cyprus or whose offer is not sufficient to cover all the needs of the beneficiaries, they may be provided by hospitals abroad with which OAY contributes. The criteria and conditions for patients to go abroad for the services covered by the GESS are determined by decisions of the Council of Ministers.
The drugs in GESY
For any issue related to the compensation of medicinal products, the Drug Compensation Council (SAF) will advise the minister accordingly.
SAF is chaired by the director general of the Ministry of Health and its members are the director general of the Ministry of Finance, the director general of the Ministry of Labor, Welfare and Social Insurance, the secretary general. of the Ministry of Energy, Trade, Industry and Tourism, the general executive director of OAY, the director of GESS and the director of Pharmaceutical Services of the Ministry of Health.
The Technical Committee for Drug Compensation, whose composition and mode of operation are determined by decree of the Minister of Health, provides advisory opinion to the SAF on issues related to the List of Medicinal Products and exercises any other responsibility assigned to it.
The curator of SAF has the general responsibility of the administrative management of the decisions taken by SAF and provides secretarial support to it, through the Pharmaceutical Services of the Ministry of Health.
The Minister of Health, after consulting the SAF, will have the authority to approve or reject the inclusion of a medicinal product in the relevant List, to determine and / or modify the amount of compensation and any other terms and restrictions for the medicinal products of the List, to remove medicinal products from the List after a reasoned decision and to exclude a category of medicinal products if this is justified on the basis of objective and verifiable criteria.
Praise from WHO and EU
The World Health Organization and the European Commission have recently expressed their support for health sector reforms in Cyprus. The World Health Organization did so in an announcement posted on its official website. The support from the World Health Organization is also expressed by the European Commission, which expresses its readiness to support the implementation of the reforms in Cyprus, contributing an amount of 2 million euros.
The European Commission's intention was expressed during a meeting convened by the European Commission in Brussels in November. The meeting was attended by, among others, representatives of the International Monetary Fund, the World Bank, the European Central Bank, the World Health Organization and the International Labor Organization. Special mention is made in the announcement of the World Health Organization in the extensive public debate that was conducted on the initiative of the Minister of Health Filippos Patsalis.
During the public debate, Mr. Patsalis had more than 200 meetings with parties, trade unions, health professionals, patient associations, organized groups and with citizens.
Source: FILELEFTHEROS