Ii was inevitable the coronavirus crisis would throw plans for the introduction of the second phase of the national health scheme (Gesy) into disarray. The original plan envisaged the start of the provision of in-patient care on June 1, but this is now looking highly unlikely, although no decision has been taken yet.
Higher contributions from workers and their employers, in anticipation of the second phase, were made at the end of March, but were suspended for April and May, as a way of helping businesses through the lockdown. In addition to this, no contributions will have been made in March and April by over 200,000 employees, who received state benefits because the businesses employing them had closed down.
Consequently, the budgeted revenue did not materialise for the Health Insurance Organisation (HIO). Revenue for the second quarter of the year (April-June) are expected to be down 55 per cent from what had been forecasted; for the third quarter revenue is expected to be down 27 per cent. According to some reports, the HIO expects the gap between forecasted and actual revenue to close at the end of 2021.
The HIO board met on Monday to discuss two reports – one about the financial situation and the other on the degree of readiness to implement the second phase – and although no decision was taken a postponement is certain. Apart from the dramatic fall in revenue, the regulations governing the second phase has not been completed – these would also have to undergo legal scrutiny before being sent to the legislature for approval.
This was not all. Negotiations between the owners of private hospitals and Okypy (the state health services) are still pending, while about half of the former have decided against joining Gesy. Everything seems to be in limbo, while some political parties are expressing fears that the difficulties being faced at present could be used as an excuse not to follow the blueprint for Gesy unanimously decided.
Needless to say, they have no suggestion on how these very real difficulties can be overcome, apart from urging the president to call a meeting of the party leaders to discuss what should be done. Unfortunately, there are no ready answers and it will take a lot more than the commitment of the parties to move to the second phase of the scheme. We know that it would not be a popular decision, but it might be necessary to go back to the drawing board when it transpires that providing in-patient care, as part of the scheme, has become unfeasible in the new economic reality.