Romania’s health service on brink of collapse
18 June 2010
Bankrupt hospitals, closed-down operation rooms, poorly paid doctors and nurses, inadequate patient care and widespread corruption predominate in the Romanian health service 20 years after the restoration of capitalism.
The austerity package recently agreed by the conservative government of Emil Boc will only worsen this state of affairs. The cuts will intensify the problems facing the country’s already inadequate infrastructure, with health costs rising precipitously as wages fall.
Despite promises not to add extra charges, the government is preparing to raise the health insurance contributions required from the population. This could increase by more than 3 percent if the proposal of the National Health Insurance Company (CNAS) is approved by the government. At the moment, contributions amount to 10.7 percent of monthly income, but if the CNAS proposals are accepted employees would pay 14 percent of their income for health services.
The government also declared its intention to implement a co-payment system for health care. Thus, patients will have to pay extra money for medical services that until now were free of charge for those insured. As a result, access to care will be an even bigger problem for poor people, or those living in rural areas with already limited access to health care.
Romania now has 435 hospitals, but only three of them correspond to European standards; the others are drastically underfunded. Suppliers refuse to deliver medicine until they receive the money they are owed, patients must bring their own drugs for treatment and sometimes even their own meals. Patients are also forced to buy vitamins, antibiotics, syringes and bandages and bring them to hospital if they need treatment.
At the end of May, a scandal shocked the country when an eight-month-old baby was sent home to die because the hospital where it was being treated publicly declared it had no money left for treatment. An official letter from the Institute of Cardiovascular Diseases in Mures spoke about the very difficult financial situation for the hospital and its inability to receive and treat patients.
This is not the only case in which a hospital placed patients in another hospital or even in the grave. Cases of women who acquired infections after being admitted at the CFR 2 hospital in Bucharest made headlines for a week in May.
Over 1,200 cases of patients who received infections while being treated in hospital were reported last year in the Cluj region. A doctor explained that these are not cases of malpractice, but result because the health system is often forced to buy the cheapest medical supplies. Sometimes supplies are brought over on ships from China. Their original wrapping can be damaged, increasing the risk of contamination.
Following discussions with representatives of the IMF, the Romanian government is going to close 150 to 200 of the 435 existing hospitals in the country and cut between 9,300 to 10,000 beds in existing hospitals.
According to recent statistics, 20 percent of pharmacies have closed since the start of the year with predictions that this figure will climb to 75 percent by the end of 2010.
At the same time more than 6,500 doctors have left the country this year already. The main reason for this exodus is that wages are 8 to 10 times higher abroad than in Romania. The situation is alarming, as several hospitals already lack personnel.
It is under these conditions that corruption flourishes. Even the simplest of treatments are only possible with the payment of a bribe. For many doctors such backdoor payments are the only way to make ends meet.
Medical tests of any kind cost a fortune. If the family doctor orders such procedures, patients are sent to endless waiting lines of the state system and are often subject to inhumane treatment.
The most corrupt element in the Romanian health service is dental treatment. Even during the Stalinist regime the state supported all dental treatments, but doctors now charge inflated rates far beyond the population’s ability to pay. Pensioners in particular and those living in rural areas can no longer afford to go to the dentist even for a simple extraction or a filling. Romania’s population occupies last place in Europe in terms of dental health.
Employees from the medical staff have joined the strikes and protests that have taken place in Romania during recent weeks. The austerity measures proposed by the Boc government will soon be implemented, and the consequences of the government’s actions will have catastrophic implications for health workers and all of Romania’s population.