The Lives Of 4.5 Million Bulgarians Will Be Endangered If Proposed Legislation Is Passed
The Bulgarian Ministry of Health has undertaken serious restructuring measures in the healthcare sector with unclear outcome.
- (1888PressRelease) July 09, 2010 - In an attempt to solve a dire budgetary crisis, the Bulgarian Ministry of Health has made a misguided legislation proposal, which, if accepted, will result in the closing of the country's most innovative and effective healthcare system.
The proposed amendments to Article 9 of the Healthcare Facilities Act demand the closing of all non-state-owned hospitals located on the grounds of state or municipal hospitals.
Among many other functioning health providers, this will mean the closing of three facilities of the Bulgarian Cardiac Institute, the only existing healthcare structure in the country operating by European standards. The Institute has brought foreign experts to Bulgaria and trained hundreds of Bulgarian specialists. Most importantly, the Institute has saved the lives of more than 5,700 acute patients to date and continues to save tens of lives a day and thousands of lives a year.
The Health Ministry is effectively economizing on quality healthcare in order to support the state balance sheet destabilized by a poorly governed economy in hopes of setting aside the money allotted to health care and buying special drawing rights from the International Monetary Fund.
In the meantime patients have no choice, but to be at the mercy of the national health fund, still the only option for primary health insurance in Bulgaria. The fund promises to provide adequate healthcare in return for the mandatory contributions of each citizen.
An unconstitutional amendment, which will cause an increase in deaths
We plead with the international community to take note of this misguided proposal as it is starkly against the interests of the Bulgarian people. Not only is it irresponsible, but it is an unconstitutional proposal, violating Article 52 of the Constitution of the Republic of Bulgaria, which stipulates that all people on the territory of Bulgaria shall have the right to affordable medical care and the right to live.
Instead of ensuring care for the well-being and longevity of Bulgarian citizens, the proposed amendments will effectively ensure many deaths caused by poor and untimely treatment for heart attacks. On a daily basis, the following regions will experience an increase in mortality: Lovech, Vratsa, Montana, Vidin, Pleven, Veliko Tarnovo, Ruse, Razgrad, Targovishte, Silistra, Shumen, Dobrich, Varna, Plovdiv, Kardzhali, Haskovo, Blagoevgrad, Kyustendil.
The facts do not support the reasoning behind the proposed legislation
The rationale given for the proposed closings is based on allegations that private hospitals operating on state premises exploit public resources and have an unfair advantage over their competitors. Thus, the Ministry of Health has proposed that closing down these facilities is an acceptable measure in the effort to cut healthcare costs.
Firstly, these allegations are false. Not only does the Bulgarian Cardiac Institute not exploit the state hospitals, but it has provided them with free expertise, professional education, significant investments and has saved more lives than the most optimistic projections of state and municipal hospitals. This partnership between public and private hospitals has been encouraged as a pivotal stage of progress by the European Union.
Secondly, and most importantly the lives saved in the Institute's centers earmarked to be shut down is an enormous improvement. In Pleven, Veliko Tarnovo and Varna alone, more than 4,000 patients with myocardial infarction have been treated in the Institute's hospitals in the last 3 years. In its first year of operation alone, the Institute achieved a 30% drop in mortality in the entire Pleven region. According to official statistics of the Bulgarian National Statistical Institute, cardiovascular mortality decreased drastically in 2008 - 3,000 fewer people died in 2008 than in 2007 - the first decrease in cardiovascular mortality for the country in decades.
The Institute's fleet of 21 ambulances are faster to respond, better equipped and better connected to the specialists that are ready to operate than any state ambulances. The facilities and practices are world-class, effective and efficient. The advanced practices and timely treatment are what has lead to the saving of lives.
This is an achievement to be celebrated and encouraged by the government, as it has been in the many letters of gratitude by patients and their families whose lives were saved and whose health has been improved by the specialists of the Institute. In addition, patients have been impressed and pleasantly surprised that the Institute's medical professionals do not take any payments "under the table" from patients, as is common practice in state hospitals. Patients are treated at no cost to them.
Thirdly, the Institute has been able to improve care by bringing to Bulgaria the much-needed foreign specialists and expertise to perform interventional procedures, improve standards of operation and train Bulgarian specialists. Hundreds of Bulgarian doctors have been trained and exponential improvements have been made in standard operating procedures. The improvements have been applauded by specialists around the world, including from the leading institution in cardiac care in the world, the Cleveland Clinic in Ohio, USA.
By recruiting leading consultants and practicing interventional cardiologists from the Czech Republic, France, Germany, Italy and the USA, the Institute has been in the leading role of modernizing and exponentially improving cardiac care in the country. If this legislation is passed, the foreign experts will be driven away and the Bulgarian specialists will increasingly seek employment abroad.
Instead of encouraging hospitals with European standards and performance, the government will discuss a proposal to close them down. The Bulgarian Cardiac Institute operates under the guidelines of the European Society of Cardiology and is constantly at the forefront of world standards of operation, something which cannot be said of almost any other hospitals in the country.
Bulgaria will go back to the healthcare level of a third world country
We plead with the country's ministers and MPs to stop to examine the facts and think about the real purpose of health reform. Is it to give a better life and health to all of us? If so, the proposed amendments are in egregious opposition to this goal.
According to data provided by the European Society of Cardiology, in 2007 Bulgaria came second to last in Europe in terms of interventional treatment of myocardial infarction (heart attack) due to the system of unequal healthcare concentrated in Sofia and Plovdiv. By the end of 2009, due to the Bulgarian Cardiac Institute, it had reached the average European level. In 2 years Bulgaria caught up with Europe, in two days it may reach the bottom and keep company with Burkina Faso.
The way forward is through innovation and collaboration, not destruction
This is not a matter of mere political squabbling. Heart disease is the number one killer in Bulgaria and in the world. Approximately one in every three Bulgarians will develop heart disease in his or her lifetime. The most important factor in saving and prolonging the lives of patients is adequate and timely care in the event of a heart attack and specialized and modern care to prevent and control heart disease.
Does the Bulgarian Cardiac Institute have a vested interest in arguing to save the Institute? Of course we do. We have spent the last three years building a first-class healthcare structure and we have invested an enormous amount of resources in the process. We want to see that structure succeed into the future and continue to serve our patients.
Does our interest coincide with that of each and every Bulgarian and European citizen? Undoubtedly, yes. The day that the doors of any of the Bulgarian Cardiac Institute's hospitals are closed will be the day that mortality from heart disease will start to rise again. It will be the day that Bulgarian and foreign doctors that work to save Bulgarian patients will start leaving the country for better opportunities, further setting the country's healthcare system back from the already dire state.
Positive change in Bulgarian healthcare will not come from disintegrating successful existing healthcare structures and disrupting the effective and efficient supply of care to patients, who are left with no adequate alternative.
Positive change will come from encouraging quality care and working together with innovative and conscientious organizations like the Bulgarian Cardiac Institute.