INDIVIDUALS and businesses will have to start contributing towards the national health scheme (Gesy) next March, but it does not look like the authorities will be anywhere near meeting the deadlines they have set themselves.
Even in the highly unlikely event that the autonomy of the hospitals – a pre-requisite for the introduction of the scheme – is completed on time the chances of private doctors joining seem very slim indeed at present.
The Organisation for Health Insurance (Oay) that will administer the scheme is currently at loggerheads with the Cyprus Medical Association (CMA) that represents doctors regarding its proposed reward system that seems designed to discourage doctors from joining. The reward scheme sets a limit on the total amounts allocated to different medical specialisations which means doctors would have no incentive to see many patients, because the average earnings per visit would decline after a certain number is reached.
Furthermore, the price per visit that Oay proposes to pay is between one third and one fifth of the current going rate for private doctors. While this may be helpful to doctors that were not very busy, those who have many patients would be signing up for a drastic pay-cut by joining Gesy. Why should they be expected to do so when state hospital doctors, nurses and other state health workers have negotiated pay increases to agree to Gesy? By what economic logic do we expect doctors that were charging patients €50 or €60 a visit to agree to be paid €12?
At these rates, only doctors who did not have many patients – those not considered the best of a specific specialisation – would have an incentive to join the scheme; the popular specialists will simply keep their private practice and charge whatever they want. The media turned on the doctors, accusing them of being greedy and claiming the CMA had kept its members in the dark about payments while former health minister Giorgos Pamboridis tweeted that 70 or 80 tax-evading doctors were threatening Gesy.
This crude populism will not solve any problem and nor will idle threats by the government to bring in doctors from Greece if Cyprus doctors refused to join Gesy. If private doctors refuse to join, there will be no Gesy and the authorities are fully aware of this. On the other hand, how much can the scheme afford to pay them without increasing monthly contributions? There are no easy answers, but all these issues must be resolved by the time the state starts taking monthly contributions from people next year.