THE COALITION government of Finland resigned last Friday, a month before a general election, because it could not deliver on a healthcare reform package. The package is considered vital in securing long-term government finances. According to a Reuters report, “healthcare systems across much of the developed world have come under increasing stress in recent years as treatment costs soar and people live longer, meaning fewer workers are supporting more pensioners.” Nordic countries have been among the most affected, added the report.
This raises a question that we in Cyprus would do well to answer. When well-governed, well-organised Nordic countries that are renowned for their planning face problems with the viability of their healthcare systems, how much confidence should we have in Cyprus about the sustainability of our proposed healthcare system Gesy to which individuals and businesses start contributing this month? Even if we leave aside the problem of the low birth-rate and ageing population, which we will encounter in the near future, could anyone safely say now that Gesy has been well-planned and will be smoothly introduced?
Signs are not good. There is a big rift between the Cyprus Medical Association (CyMA) and the Health Insurance Organisation (HIO) that will administer the scheme, with many specialist doctors refusing to register. The chairman of Okypy, that will run the state hospitals, tendered his resignation last week because of criticism over his appointment by the auditor-general. Staff employed at state hospitals have refused to sign contracts with Okypy which will be their new employer, because they would not have the same benefits and privileges they had as public employees.
Meanwhile, state hospitals will carry on being subsidised by the state for the foreseeable future (a five-year deadline has been set but we doubt it will be met) thus competing unfairly with private clinics and hospitals and having no incentive to improve efficiency and cut costs. The association of private hospitals and clinics has threatened not to join Gesy because of the unfair competition, raising doubts as to whether there would be enough hospital beds to satisfy the needs of all Gesy patients.
Some claim this will be sorted by next year when Gesy starts to offer in-patient care, but it is a superficial argument. It is as superficial as the insistence of politicians that the scheme should be introduced and all difficulties would be sorted out as we go along. This approach runs the risk of bankrupting the scheme and putting that state under big financial pressure because the costs of the scheme could soar. What would happen if we discover a year after the introduction of Gesy that it is unviable without the injection of huge amounts of money?
Having experience of how big projects organised by the public sector go significantly over-budget, could anyone believe that Gesy will be an exception?