Cyprus Mail

CM editorial grabbed at the chance to malign Gesy and promote private healthcare

Patients queuing up for drugs at the pharmacy

In the Cyprus Mail editorial on June 12 you claimed that the Commission for the Protection of Competition was more interested in protecting Gesy monopoly than competition. You obviously have no idea what you are talking about.

Let’s start with some facts. The Gesy law provides for the establishment of the Health Insurance Organisation (HIO) which is responsible for implementing a “general healthcare system”, Gesy. It also provides for the establishment of a fund to which all Cyprus residents, who are income earners, contribute according to the level of their income. This is compulsory. The HIO is also responsible for managing the fund. The law does not provide for the compulsory participation of healthcare providers. This is entirely optional.

Yet you claim that “the objective of Gesy is to establish a monopoly”. A monopoly (a Greek word meaning single buyer) exists when the sale of a product is exclusively restricted to a single supplier. For a start, Gesy, or more accurately the HIO, does not sell anything. HIO simply buys healthcare services from those who choose to join the system and reimburses them from the aforementioned fund.

If there was a market situation, which could describe Gesy it would be a “monopsony” (another Greek word meaning single buyer). But not even that totally reflects reality in Gesy’s case since many other entities can still buy healthcare services and sell health insurance. Gesy law does not forbid this.

You state: “if there is one body that is against competition it is Gesy”. In fact, it is the exact opposite.

There are two fundamental elements to competition. Price and quality. Under Gesy, the element of price does not exist, since healthcare services are accessed by citizens without direct payment to the provider. So citizens choose their healthcare service provider solely on the basis of quality, which is exactly what Gesy achieves. Under the present “free” system (ex-Gesy) where the element of price exists, some people get cheaper and lower quality services, and those who can afford it, get more expensive and higher quality services. Is this what you are advocating? Just look at the USA healthcare system and its consequences, where health insurance premiums are extremely expensive; tens of millions are without access to health services and yet total health expenditure is at an astonishing 18 per cent of GDP (highest in the world). No thanks!

Gesy promotes competition between service providers based on the quality of service.

Perhaps due to ignorance you are confusing the healthcare service providers with health insurance companies (middlemen/brokers), which means you are in favour of a multi-insurance system. If that is the case then you have to explain who is going to pay for the profit which these “brokers” rightly expect to make. It can only be the citizens, employers and government through increased contribution rates or the healthcare service providers (doctors, hospitals, etc) through reduced reimbursement rates. I dare you to suggest that to either of them!

A healthcare system does not need ” profit making middlemen”. Health is not just another commercial good, but a public good and a right and, as such, should be universally and easily accessible by all citizens, irrespective of their financial capacity. The provision of this invaluable public good must not be left uncontrolled and at the mercy of either commercial exploitation or the failures, fixations and dysfunctions of the public sector. Patients are not like all other consumers, who choose what and when to buy a good. Patients do not choose to be patients. Nobody chooses to be ill.

You just grabbed the opportunity presented by the CPC investigation to attack Gesy and its “monopoly”, and covertly promote and support the commercialisation of healthcare. It is very sad that some politicians follow suit.

It is time all accepted that Gesy is here to stay. The implementation of Gesy is not simply a choice which the state is called upon to make. It is an absolute necessity for any modern and developed society. As such, everybody, including the media, should do all they can to secure its success for the good of the people and not for a handful of companies.

Christophoros Georgiades, former HIO director

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