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Our View: Business model for Gesy is doomed

The Health Insurance Organisation (HIO) has decided to set limits on the number of patient visits per day for certain specialist doctors. This was inevitable given the way the national health scheme (Gesy) was designed and marketed by the HIO.

It is a free-for-all scheme based on the unreal assumption that Cyprus’ resources are inexhaustible. Patients can visit specialist doctors as often as they like, demand free cardiograms, MRIs, scans etc even when these tests are not justified. Specialist doctors were free to book as many appointments as they wanted, seeing patients even when there was no need, because this increased their earnings. Personal doctors could earn money just by registering patients and were being paid throughout the lockdown for seeing nobody, not to mention that the annual income for some was in excess of €200,000.

As for state hospital doctors, they also secured hefty pay rises – so their income would be closer to Gesy doctors without giving anything back in exchange. They still work civil service hours so hospital operating theatres are not utilised after 3pm nor will patients be seen. These hospitals will now also hire a couple of hundred of nurses at wages 50 per cent higher than the average wage of nurses in the private sector.

The HIO business model – grossly overpaying private doctors to persuade them to join Gesy, markedly raising the wages of government doctors without any increase in productivity and making the income of specialist doctors dependent on the number of visits, and making patients think they have the right to seek medical care whenever they have nothing better to do – is doomed.

The financial problems being encountered by the HIO are the direct result of this unviable business model and not because people’s contributions to Gesy had fallen as a consequence of the lockdown. The lockdown simply brought forward the financial problems inherent in the free-for-all scheme that is designed for abuse by stakeholders rather than viability. This is why the HIO has now decided to set limits on the number of visits to obstetricians, gynecologists, dermatologists and urologists etc. It is also trying to set limits on referrals for MRI scans, stress tests etc.

Can a healthcare system designed so incompetently be fixed without sparking a revolution by the stakeholders that have been given licence to milk it dry and patients made to think that they can demand to see a neurologist or have an MRI scan if they have a headache for two days? There is no question that Gesy needs radical rethinking and re-design if it is to survive, but this is not a job for the HIO, the inadequacy of which has been laid bare by what is happening now.

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