LESS than two weeks ago the board of the Health Insurance Organisation (HIO) met to discuss the possibility of delaying the start of second phase of the national health scheme Gesy by a few months. The second phase, which involved in-hospital care was due to start on June 1, but the coronavirus crisis had turned plans upside down, drastically reducing forecasted revenue and putting public hospital preparations on hold. This made the postponement a reasonable option.
On Monday, however, health minister Constantinos Ioannou said the second phase would start on June 1 as planned and any difficulties that would inevitably arise would have to be dealt with. The money issue would have to be resolved through the renegotiation of prices agreed with personal doctors and private hospitals, said the minister, as if this were a straightforward undertaking that could be arranged in a few days.
The initial plan was for workers and businesses to increase their monthly contributions to Gesy from March in preparation for the second phase. With thousands of workers furloughed in March the contributions were drastically reduced and the situation was much worse in April; May will not be very different as many businesses will not open until the 21st. Add to this the government’s decision to suspend the increased contribution for these two months to help businesses and it becomes clear that Gesy will have much less revenue than it had budgeted going into the second phase. Some reports suggest revenue for second quarter will be down by 55 per cent.
Ioannou said the HIO could improve its finances by renegotiating the rates it agreed with personal doctors, which were ‘provocative’ and persuade private hospitals and clinics to accept lower payments for a few months. How likely is this, considering the Pasin which represents private hospitals and clinics had not even been consulted about a cut in the rates agreed? If the HIO fails to persuade private hospitals and clinics to accept cuts how will the second phase operate?
Another issue further complicates matters – the decree forcing all hospitals and clinics to operate at 60 per cent of their capacity in case there is a resurgence of Covid-19. Even if the private hospitals participating in Gesy agree to the cut in prices, they will inevitably give priority to private patients and have limited capacity for Gesy patients. In short, the second phase will commence with very limited in-patient capacity.
Demand for operations, meanwhile will be very high as none were performed in the last month and a half because of the coronavirus, while many patients were delaying having operations until June so they could have them under Gesy at private hospitals. By the minister’s admission, we would be looking at very high demand for operations and 40 per cent per cent lower availability than normal, and this is assuming private hospitals agree to join. If they do not, and given the shambolic situation at public hospitals, the second phase will exist only in theory.