The health system is affected by corruption and the authorities admit this. In Moldova, the people offer bribe to doctors even if they have health insurance and officially benefit from free services. According to statistics, the informal payments represent 40% of all the payments in the health system. IPN News Agency asked the election runners what solutions related to the current mandatory health insurance system they propose for the medically insured persons to benefit from medical services of a high quality without offering bribe to doctors and for the doctors to be motivated not to ask for money, while for the salary earners to be motivated to pay honestly health insurance contributions.
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Health system necessitates modernization and increased financing
The Democratic Party of Moldova considers the national health system needs to be modernized and optimized and to be allocated increased funding. The efforts made over the last few years must be continued and emphasis should be put on the accessibility of the medical services. There is no place for dissipation and corruption in this area. The inflated costs of hospital purchases of medicines and medical equipment and bribery represent realities that must be eliminated from the health sector.
To motivate the doctors not to ask for money, the salaries of doctors and nurses should be substantially increased, but this cannot be done swiftly. Progress has been yet made. This summer, the tariff salary in healthcare was raised by 21%. The pay raises will continue. The dissipation in this system should be removed. If the people see that the funds for health are used correctly, they will be motivated to honestly pay health insurance contributions.
More medical services included in the heath policy
The Christian-Democratic People’s Party said that the medical institutions should be outfitted with the necessary medical equipment and devices, while the salaries of doctors, doctor’s assistants and nurses should be increased up to a satisfactory level. The range of medical services covered by the health policy should be extended, while the penalties for the non-payment of the health polices for persons who do not have incomes should be eliminated and the state should make sure that these persons benefit from medical services free of charge. Corruption should be rooted out by exemplary punishments. The doctors must have high salaries, while the people must have sufficient incomes for paying the health policy.
Systems to ensure self-management of health insurance funds
The Liberal Reformist Party considers it is necessary to modernize and optimize the health system and to institute an integrated system for improving sanitary indicators: health, sport, consumer protection, food safety. The health insurance system must be restructured by eliminating bureaucracy and the monopoly of the National Health Insurance Company and by introducing a system to ensure the self-management of the mandatory health insurance funds.
Administrative decentralization is required. The informal payments must be removed from this system by promoting cost-efficient reforms. The people’s access to essential health services must be improved by redefining the role of the components of the health system. The medical personnel can be motivated not to ask for money by gradually raising their salaries. The personnel should also be subject to integrity tests before being employed.
Fines for persons in need should be removed
The National Liberal Party believes that providing services for money in state medical institutions financed from the state budget is inadmissible. The salaries of doctors should be raised and the private health protection institutions should be allocated money for compensating the budget costs planned for a person. The penal legislation should be amended so that the declared and recognized persons in need, who cannot purchase a health policy, are mot penalized, but are issued with free health policies.
The price of health policy should be reduced by 30%
The Socialist Party of the Republic Moldova pledges to reduce the price of the health policy by 30% and to take other measures such as the institution of the mandatory annual medical examination for people, covered with budget money, and provision of compensations in cases of malpractice. The pensioners, invalids and children younger than 18 must be provided with medicines and dental services free of charge. At least one medical post must exist in every village. The prices of drugs must be subject to rigorous control and a network of social drugstores must be created. The profit margin on drugs will be limited to 7-10%.
The doctors take bribe because they receive low salaries and do not have confidence in the future. Among other reasons are the considerable underground economy and the imperfection of the legal system. The party will create decent working conditions for doctors and appropriate salaries. With the development of economy, the people’s confidence in the security of their savings and the hope for a safe life after retirement will increase. This will be a stimulus for abandoning the payment of salaries ‘in envelope’. The improvement of the legal system will allow efficiently fighting corruption, while the doctors will value more their jobs.
Size of salary must correspond to status of doctor
The People’s Party of the Republic of Moldova is for setting the salaries in accordance with the status of doctors. Though doctors’ salaries were raised to 3,873 lei in 2013, they remain two times lower than the pays in the financial sector owing to the inflation rate and the rise in the consumer price index. The young residents only from this year will receive a salary of doctor of 1,100 lei, besides the monthly scholarship of 900 lei.
The hospitals must be outfitted with modern equipment so that the mandatory health insurance system is reformed by facilitating the private medical institutions’ access to public money. The workers from the health system must be motivated by being paid appropriately and by improving the working conditions.
Financing allocated to health system will be augmented to 8% of the GDP
The Liberal Party considers it is absolutely necessary to promote culture and a healthy lifestyle so as to increase the length of life and the quality of life and to simultaneously strengthen medical assistance and improve the quality of the provided services. For these objectives to be achieved, the financing allocated to the health system must be gradually raised to 8% of the GDP, including by attracting international investments and developing public-private partnerships and private health policies that will be in competition with state health policies. Thus, a part of the medical staff will benefit from better working conditions and higher salaries, while the people will enjoy increased access to adequate medical services.
The motivation of doctors to provide services of a high quality and to show good faith in the relations with the patients is directly related to the financial benefits. The rise in the funding for the public health system to levels comparable with those in the EU, together with the attraction of foreign investment, represents an important step towards increasing the salaries of medical personnel. The development of private health policies will have a positive impact on the honest payment of contributions by the beneficiaries.
State functionaries must have motivating salaries
Independent candidate Oleg Brega said that the next government must amend the laws possibly by a model borrowed from countries that managed to root out corruption. It is not necessary to invent the bicycle. But it seems that the party politicians are not interested in changing the situation because, when they come to power, their clan gains benefits from the generalized corruption. The state functionaries must have rather high salaries so that they are motivated, while the taxes should be rather low so that their payment is acceptable. The inspections and fines must be frequent and fair so that they discourage tax evasion.
Health insurance system is good, but must be transparent
The Green Ecologist Party considers that transparency should be first of all ensured. Any minister should communicate directly with the people. For example, the minister of health should take part in a direct program on the public TV channel, without a host, and should answer people’s questions live during three hours. There is now no transparency and the population is not informed.
The Greens consider that the current health insurance system is good, but should be applied transparently. The doctors must be motivated by increasing salaries. The party designed a project aimed at raising the salaries of medical staff and teaching staff to the level of the salaries of MPs.
National Health Insurance Company must openly report accumulated and used resources
The Centrist Union of Moldova thinks the state must be responsible before the people. The money collected from employers, employees and non-working people must be managed transparently. The National Health Insurance Company must monthly, quarterly, half-yearly and yearly provide detailed information about the accumulated resources and the spending. For the purpose, a supervisory broad should be created at the company, which would include only representatives of civil society. This board will have enough powers to ensure the rational use of the collected moony, including the veto right on illegal decisions to irrationally spend the money.
Doctors’ salaries must be raised without delay. The doctors who will be caught taking unofficial payments musty be penalized, including by being banned from practicing for life.
Note: IPN News Agency asked all the election runners to state their views on the given issue. The article contains the answers provided by the agreed date. The IPN series of materials produced before the November 30 parliamentary elections will continue with other important issues identified by the public opinion.
Elena Nistor, IPN
