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News 08 Jan 18

Protest Threatens to Leave Many Romanians Without Doctors

Over 4 million Romanians may have to pay for their primary medical care, or change doctor, after 2,500 general practitioners refused to sign contracts with the government. 

Ana Maria Luca
"Insurance money, joy of thieves" reads a banner at a family doctors' protest in November 2017, in Bucharest. Photo: Adel al-Haddad/Inquam Photos. 

Over 4 million Romanian patients will have to pay for primary medical care or register with another doctor in 2018, after 2,500 family doctors said they would not cooperate with the government health insurance company as part of a protest against red tape and a lack of funds.

Family physicians associations protested last week against what they deemed a lack of interest on the part of the government in primary medical care.

Doctors say the government health insurance company, the National Health Insurance House, CNAS, buries them in paperwork and does not reimburse the whole cost of medical care.

Doctors protested on January 3 by refusing to issue compensated prescriptions and announced that consultations would now be pro-bono. Many of them refused to renew their contracts with the government.

They want the government to increase the budget for primary medical care from 5.8 per cent to at least 9 per cent of the total amount assigned to medical care.

The doctors said they have been urging the government for years to change legislation in the field, so that contracts with the insurance company are less rigid and involve less paperwork.

However, the Minister of Health, Florian Bodog, has denounced the protest as irresponsible.

“I apologize to patients and I find it extremely unprofessional to use the suffering and conditions of all these patients in negotiations,” Bodog said on Thursday.

The National Health Insurance House on Thursday said 75 per cent of family doctors had signed the contracts already.

However, that leaves another 2,500 doctors, serving 4 million Romanians, unwilling to issue compensated prescriptions.

The health insurance company has found a short-term compromise by issuing a list of 59 conditions that do not require referrals from doctor for prescriptions.

“Alternatively, they [the patients] can simply transfer to another family doctor,” a CNAS spokesperson told BIRN.

Doctors’ associations say that the government simply forced their members into signing the contracts, despite their unwillingness to do so.

“It is understandable that many of our colleagues signed because the pressure was and still is huge,” the president of the National Union of Family Doctors, Rodica Tanasescu, told BIRN.

The consequences of not taking into consideration the grievances of the doctors will become visible within a few years, she added.

“Young doctors will not choose family medicine during their internship, or they will choose to leave the country,” she warned.

Romania faces a major healthcare crisis. Some 15,700 doctors have left the country since it joined the European Union in 2007.

This has left about 600 towns and villages without any primary medical care, according to a study released in December by the Romanian Association for Health Promotion.

The Bucharest branch of the National Health Insurance House is also at the core of a major fraud investigation that anti-graft prosecutors started in 2017.

Some 30 people are under arrest for allegedly embezzling 3 million euros between January 2016 and August 2017. In an organized network, high-ranking officials fabricated medical records for fake patients in order to claim insurance money. 

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