OUTPATIENT health care under the National Health Plan (NHP), which will include primary care by doctors, secondary care by specialists, as well as medicine and diagnostic examinations, will be available to the public by sometime in 2008, Health Minister Charis Charalambous said yesterday.
The plan was first conceived in 1992 when a group of experts prepared a study on the health care system in Cyprus and proposed the creation of a National Health Plan based on communal solidarity and universal coverage.
In 2001, the law for implementation of the plan was voted upon, calling for the financing of the plan through contributions from workers (two per cent), employers (2.5 per cent) and the government (4.8 per cent).
EU studies have found that Cyprus presently has a disproportionate amount of expenses in the private health sector (56 per cent) compared to the EU average of 26 per cent.
The Health Minister characterised the need for the new plan particularly urgent as the problems of the present health care system have become “more visible in the last few years”.
“The main cause of the problems is, among other things, the lack of competition and cooperation between the public and the private sector in providing health services, which leads to the downgrading of services offered to citizens and to the waste and coverage of services,” Charalambous said.
President of the Organisation of Health Security, Kyriacos Christofi, said that there were two main reasons for the need for a national health plan.
The first, he said, was the “great concern and uncertainty on part of Cypriots as to what happens if they have a serious illness or accident that can lead to the financial catastrophe of the entire family.” The second was that the EU accession of Cyprus “forces us, as it does all EU countries, to impose a national health plan”.
Axel Baur of the McKinsey & Company, which the government selected as a consultant, said that the present system is “not sustainable” for three main reasons.
“At present expenditures are going double the pace of GDP,” Baur said, noting that that the present system creates a high financial burden on all parties due to uncoordinated development between public and private sector, which leads to inefficiencies, and to a “lack of responsibility and accountability”.
Christofi said that co-payments, deductibles and syntaxes on goods like tobacco and alcohol, might be included to discourage wasteful behaviour and ensure that the public does not take undue advantage of the free system by going to the doctor on a whim.
The law for the NHP foresees universal coverage, mandatory participation – with high-income groups paying more than low-income groups without receiving preferential treatment – and the free choice of a family doctor.
At present the plan does not cover dentistry for anyone over 15, but the government is considering also allowing for collaborations with private insurers so that people interested in coverage for non-essential health care and goods such as plastic surgery, and “lifestyle medicines”, as well as for dentistry, have the option for such insurance.
The Health Minister said that the plan should be fully implemented within four years.
A law is also being prepared for submittal to Parliament that would allow for autonomous management of hospitals as semi-governmental organisations – beginning with the Nicosia General Hospital – in an effort to reduce inefficiencies.
When asked about how the plan applies to Turkish Cypriots, Charalambous said that the Health Ministry merely deals with the implementation of the scheme.
“That depends on the policy of our government and the way that it wants to handle the issue of the health of Turkish Cypriots,” he said.
