About 38.000 people, according to the data of the Republic Health Insurance Fund (RFZO), are waiting for a medical procedure. The largest number of them (27.000) are standing in line for the installation of a hip or knee prosthesis. For example, those who applied at the beginning of August will wait in the hospital in Banjica for four years. writes Deutsche Welle.
We are also waiting for procedures without which we can live almost on the verge of death. Let's say heart bypass is waiting at the Clinical Center of Serbia for nine months.
Private clinics offer these operations at a price of several thousand euros, so the decision is up to the patient - either pay for a private doctor, or live for several years in pain and uncertainty.
Danijel Raspopović, an orthopedist from Banjica and a member of the Health Committee of the Freedom and Justice Party, told DW that the main culprit for waiting lists is the poor organization of the Ministry of Health as well as corruption. There are also objective reasons:
"The operation itself, if there are no complications, which is difficult to predict in surgery, lasts about an hour on average. However, another problem is the time between operations. It cannot be speeded up, it takes time to put the patient under anesthesia, to take him out of the room, to prepare the room."
The first to smile
"Serbian Roulette"
How to solve the problem of the waiting list is shown by the example of cardiac surgeon from Niš Dragan Milić - now a local politician. He was able to eliminate waiting lists while running a cardiovascular surgery clinic. He tells DW that they managed to do it by working continuously for four months.
Milić explains that one cardiac surgeon can perform two operations per shift.
According to Milić, the main problem in healthcare is corruption. He claims that waiting lists are long so that private practice "has more work." He calls the fact that he waits for months for a bypass "Serbian roulette".
"That is unacceptable. Heart patients cannot wait, because they lose their head, not their quality of life, like people who are waiting for a hip or knee prosthesis to be installed. They should not wait longer than a month," says Milić.
Patients are not aware of their rights
As lawyer and MP of the Green-Left Front Marina Mijatović, whose specialization is patients' rights, explains, citizens have the right to a refund if their rights have been violated.
"Patients' rights to access to health care and the quality of health care are being violated. It is common knowledge that for the services defined by the Ordinance on waiting lists, the wait can be several years, and it is forgotten that the Ordinance foresees the longest wait of one year. Every patient who waits longer has the right to access to health care violated," says Mijatović.
In the case of installing artificial heart valves, the deadline is one month, while according to the Rulebook, the deadline for installing bypasses is up to six months.
"If the patient sought the service in the private sector, he could submit a request for reimbursement to the RFZO together with a medical report and bill. If the RFZO rejects the request, the patient can appeal, and after the appeal, a lawsuit can be filed with the Administrative Court," says Mijatović.
In practice, few people go that way. RFZO, he says, routinely rejects requests claiming that reimbursement cannot be sought for services on the waiting list. "That is a completely wrong interpretation," claims Mijatović.
Cataract waiting lists: Now you see them, now you don't
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Health Minister Zlatibor Lončar claims that work is being done to solve this problem, who recently stated that in state institutions the waiting list for operations has been reduced by almost 90 percent, that some centers that did not do it before have joined the cataract operation, but hip and knee operations remain a problem.
That information is partially correct, because in September of last year, when this issue came up, almost 70.000 citizens were waiting on the waiting lists for various diagnostic and therapeutic procedures run by the RFZO - twice as many as today.
However, there are more people waiting for a hip or a knee than there were then.
Loncar denied that lists are shortened by simply deleting people from them. However, in January, waiting lists for cataracts disappeared from the RFZO website. All that remains is a link to the presentation of the Ministry of Health, which claims that the lists have been abolished.
Draško Karađinović, from the non-governmental organization Doctors Against Corruption, told DW that one should be skeptical of the data published by the RFZO.
"If it has not been possible to have insight into the annual financial reports of the RFZO for years, and billions of euros are being spent, then there is clear skepticism towards the data provided on the website. It should also be noted that the list of services for which the RFZO keeps records of waiting lists is very selective and does not reflect the reality that awaits a patient in a health center or hospital," says Karađinović.
DW interlocutors point out that a systemic solution is not in sight, but explain how it could look like. Karađinović states that "we should not invent hot water", but look to successful models.
"The first measure is the de-monopolization of state healthcare, primarily in the sector of ambulatory medicine, i.e. primary health care and one-day medicine, which would open the possibility for the insured with a card to choose the doctor where he will be treated, and for the money from his contribution of 10,3 percent of the gross salary to accompany him and finance his treatment in the state or private sector," says Karađinović.
Slightly more than 20.000 doctors work in the Serbian state healthcare, while there are about 5.000 in the private sector.
However, Savo Pilipović, president of the Association of Melanoma Patients, claims that a complete reset is needed. The interlocutor of DW states that the current healthcare system does not focus on the patient, nor on the doctor.
"The patient must be in the center, and now he is not even on the periphery. We have to discuss what we want from the health system, how much money we want to invest. What is it that we will not treat at state expense, and what is the priority," says Pilipović.
