AS MUCH as the authors of the national health scheme have tried to insulate Gesy from the effects of the market by setting up a monopolistic system with fixed rates, it does not look like it is working out. Shortages are already being experienced at the state hospitals which are being abandoned by doctors that want to set up their own practice and sell their medical services to the scheme.
Since the start of the year, some 30 doctors have left the state hospitals, said the leader of the government doctors’ union Pasyki, saying 15 of these had left the A&E wards. This is happening at a time when the state medical services Okypy is advertising vacancies for doctors at state hospitals. Interest for jobs at the hospitals was underwhelming said a spokesman for Okypy, which had sent new proposals to the unions offering higher rewards to doctors.
With few specialist doctors with private practices having joined Gesy, there is an acute supply shortage, which hospital doctors see as an opportunity to substantially increase their monthly earnings because there will be big demand for their services. Not all will quit the hospitals, and the incentives offered could slow down the departures, but the forces of supply and demand could create a problematic situation.
This was, to a large extent, the result of not enough private specialist doctors joining Gesy because they felt the rate per visit they would be paid was not enough. They would be paid about a third of what they receive per visit privately, which would mean they would have to see three times as many patients in Gesy to make the same amount of money. It was not an appealing prospect for them, whereas it was for hospital doctors that were paid a fixed salary regardless of how many patients they saw each day.
Meanwhile, a few doctors that signed up for Gesy as personal doctors are reportedly quitting the scheme because, apart from having to cope with too many patients, they also have to engage in many hours of mind-numbing administrative work for which there is no payment. The high demand for the services of personal doctors, is inevitable given that healthcare provision is now free and supply cannot cope with demand. There are already complaints the scheme is being abused by people, putting it under additional strain, which is why the Health Insurance Organisation should perhaps use economic thinking to find a solution.