Supplementary Work of Doctors in the Private Sector Divides the Strongest Parties on Healthcare

All three strongest political options, ahead of the parliamentary elections on September 11, promised citizens on Monday universally accessible and solidarity-based healthcare, including private providers where public healthcare capacities are insufficient. The separation of the public from the private sector, as well as their cooperation, under the condition that private providers agree to the prices that HZZO pays to the public sector, is a matter on which all three potential health ministers from the People’s Coalition, HDZ, and the Bridge of Independent Lists, Siniša Varga, Drago Prgomet, and Ivan Bekavac, agreed at a round table dedicated to healthcare organized by the Croatian Employers’ Association (HUP) and the publisher Hanza Media.

To reduce waiting lists and ensure timely and quality healthcare services, private providers need to “jump in” where the public health system lacks sufficient capacity, say representatives of the three political options that are receiving the most votes in pre-election polls for the parliamentary elections next Sunday.

Employer representatives – Zoran Knežević and Marina Pulišić warned that this year, ahead of the elections, the “same scenarios and stories” are repeating regarding healthcare, where similar problems have been accumulating for years. Knežević stated that the current minister Dario Nakić has not managed to find time to meet with HUP representatives in his eight months in office. He also highlighted the unsustainability of the HZZO price list for diagnostic-therapeutic groups (DTS), according to which HZZO pays 50 kuna for a cardiological examination, which then lasts 8 minutes in a public hospital. On the other hand, he says, a private cardiologist will charge 250 kuna but will dedicate half an hour to the patient.

Marina Pulišić from Jadran-galenski laboratorij (JGL) warned of the “too slow, uncompetitive healthcare administration, slowness in adopting regulations and measures, and lack of transparency in their implementation.” She also pointed out the poor treatment of the domestic pharmaceutical industry and the need to reduce VAT on over-the-counter medications, which currently stands at 25 percent, compared to 5 percent on prescription medications.

Prgomet stated that his party wants to clearly separate public and private, but also to include the private sector everywhere in the system where public health cannot meet patient needs, while Bekavac deemed it irresponsible that “patients wait, and do not use private resources at the expense of public health.”

Varga also asserted that patients do not care where they receive healthcare services, funded by public money, as long as it is quality, timely, and without additional payments. He emphasized the revenues in health tourism, which currently amount to 1.2 billion kuna annually in the private sector and about 800 million kuna in the public sector, and stated that a model must be found so that healthcare staff benefits from such services.

However, representatives of opposing political options did not agree on the issue of supplementary work of doctors in the private sector. Prgomet is strongly against supplementary work, while Bekavac emphasizes that it is a European practice and that otherwise, doctors will leave Croatia even more. Zoran Knežević warned that “illegal work is still flourishing” in Croatia, as doctors in public institutions continue to direct patients to themselves privately. They do not issue invoices for private services nor pay taxes. “We all know about them,” said Knežević, to which Bekavac, the current Deputy Minister of Health, called for such cases to be reported to the Ministry, which will send inspection oversight.

HUP representatives also warned about payment deadlines to suppliers, which now average around 200 days in healthcare, to which Prgomet responded that the HDZ administration, by strengthening the economy and GDP growth, will achieve that payment deadlines are reduced to the legal framework of 60 days.

Although the topic of the meeting was not patients and waiting lists, participants touched upon this issue as well. Siniša Varga thus promised that through reform and rationalization of the system, he would eliminate waiting lists.

– We have reduced waiting lists, but the current ministry has again returned them to 800,000 patients waiting, said Varga, which Bekavac deemed “irresponsible promises of the SDP candidate.”

– It is irresponsible to talk in Croatia about eliminating waiting lists, which exist, for example, in Austria and Germany. The key question is how to secure funds for healthcare costs that are growing annually by 3 to 8 percent, so that in a few years, Croatia will need 30 billion kuna annually for healthcare, said Bekavac.

Zoran Knežević believes that the only answer lies in GDP and economic growth.

– We are currently in a situation of exiting the crisis. We need quick solutions that will primarily satisfy patients, said Knežević.