Eugen Nicolaescu to privatize the Healthcare System with public EUR billions. See below the political mob group in the Ministry of Health
Postat la: 25.02.2014 - 12:01 | Scris de: Ziua News
Eugen Nicolaescu decided to privatize the Romanian Healthcare System by using EUR 14 billions of state funds. More than Oltchim and CFR Marfa, the Healthcare system will receive an enormous amount to be restored and prepared for a subsequent sale.
By Monica Cosac, Voichita Rascanu, Ruana Ceausescu and Eduard Pascu
Eugen Nicolaescu, known as "Jeni" among his friends and as Minister of Health by the rest of us, intends to privatize the Romanian hospitals, according to his public statements of the PNL member of the last eight years. Strangely, the Minister of Health has invented a new type of privatization: first he spends EUR billions for the so-called restoration of the healthcare system and later gives it away to private healthcare operators. Nicolaescu's plan is not new and has benefitted from the support of a strong political mob group that simply covered all healthcare units and bodies, from hospitals to public medical insurance agencies and even the state budget. ZIUAnews presents below the thoroughly planned disatrous method of directing each taxpayer's money in the last 20 years towards the deep pockets of certain businessmen loyal to the political class.
As of 1989, when the Romanian Revolution happened, approximately EUR 20 billions were used by the healthcare system. No new public hospital has been built, quite the contrary, many were closed down. Essential medicines lack for years, even in the Emergency Admission Units (EAU). Hospitals are known as genuine pestholes, the sterilization products and materials are most often missing, patients are admitted with one disease and get four more in the hospital, the food is not compliant with the nutritional standards, bedlinen and sheets are given from one patient to another. Thousands of doctors have already left to work abroad and those who are still here recommend their patients to seek treatment abroad, doctors are accused of malpractice on a daily basis. Except two minor cases, doctors and hospitals have never paid for their mistakes and damages they caused. Six newborns suffered lethal burns in one of the largest maternity wards in Bucharest, Giulesti. The fire started from an overcharged socket. The tragedy could have been the moment to start a true reform of the healthcare system, should it have been wanted to. However, one year after the tragedy, the Neonatal Unit reopened in exactly the same conditions, with an equally malfunctioning electrical equipment and without running hot water. The hospital manager told one of his doctors that if he insisted on having running hot water an electric boiler could be installed in the room, while he was releasing press statements according to which the investment in reopening the unit (which meant a layer of wall paint and three beds) cost more than EUR 1 million.
EUR billions and the healthcare still in a coma
Irrespective of the political alliances along the time, the Ministry of Health turned into a PNL (National Liberal Party) business, directly coordinated by ministers or indirectly by PNL leaders through their state secretaries, state sub-secretaries and directors. Thus, the PNL leaders were behind all the healthcare system manoeuvres.
"According to our most recent calculations, EUR 12-14 billions are necessary for Romania to update its medical infrastructure to the highest standards, including medical units, hospitals, laboratories and all the rest", Eugen Nicolaescu said.
Prior to this statement, the same minister declared that he intended to introduce private practice medicine in the public hospitals and to transform local or town hospitals into foundations or associations. Thus, a pilot program was implemented for ten hospitals preparing for the major change to come.
The Government announced that the 2014 budget for the Ministry of Health is LEI 7.9 billions, while 2013 estimates ran up to LEI 5.6 billions. Sources in the Ministry of Health declared for ZIUAnews that Eugen Nicolaescu would try to obtain EUR 12 billions from the state budget, four out of which would be directed towards SMURD and Emergency Admission Units. The money would be received by the SMURD Foundation, using Raed Arafat again as the public healthcare system's saviour. In order to obtain this money the doctors' strike was carefully planned by SANITAS (Medical Professionals' Union), an important player in this scheme that defends the PNL interests, as you will read in the following pages. Coincidently or not, stories of doctors forced to commit malpractice in the absence of necessary tools came out in the media.
Public appreciation for Arafat, shield for manoeuvres
Raed Arafat was appointed State Sub-Secretary in the Ministry of Health in 2007 by Calin Popescu Tariceanu, PM at the time. Arafat kept his position in the Ministry of Health irrespective of the political party running the country. He inaugurated clinics along with Boc Government officials and, when it came to closing down small hospitals, it was Raed Arafat who announced it publicly. This decision was harshly criticised at the time by the current Minister of Health: "Arafat was sent forward to support the Boc Government measures because so many people like him and would be less angry when Arafat seems to support the measures (...). When your minister asks you nicely to support these projects, considering them essential for the Government's policy...what could he have done? Support the measures or hand in his resignation."
However, in January 2012 Arafat resigned from his position as State Sub-Secretary after President Basescu announced his intention to privatize both the emergency healthcare system and the public medical insurance agencies. Tens of thousands of people protested in the street, in winter, for more than two months. The protests became violent and the intervention of Romanian Gendarmerie was required. Basescu dropped the idea and Arafat returned to his previously held position in the Ministry of Health.
Arafat was asked several times to accept the Minister of Health position but he only accepted it briefly for six weeks in the Ponta Government to later become State Secretary and the front person whenever a situation impossible to manage by Eugen Nicolaescu arises, like "The Hospital of Death" in Ploiesti. Should it be the same "sympathy" of people for Arafat that Nicolaescu considered used during the Boc Government to deliver the less than happy news?
Robbery of the public medical insurance agencies
The mob political group within the Ministry of Health proved to be efficient and keep all the irregularities well concealed. It became a closed system where members have two options: either to support those who actually run the healthcare system and distribute the money according to their wishes but not to hospitals or to leave the country.
The public medical insurance agencies have been robbed of their funds but would be the most profitable private companies countrywide. Take the Bucharest Public Medical Insurance Agency, for instance, which receives a monthly EUR 3 millions. The money is absorbed by the state budget, as regulated during the Adrian Nastase Government.
EUR hundreds of thousands bribery for a NMR
The technical-economical committee in the Ministry of Health is the actual body behind the "games" in the healthcare system. The committee members approve all purchases made by hospitals countrywide, with bribes reaching fabulous amounts. Once in the healthcare business, one can become rich from one day to another. In order for a hospital to purchase a NMR, for instance, the bribe ranges from EUR 100 thousands to EUR 200 thousands, for a piece of equipment bought as used and not state-of-the-art, right from the producer's plant, as it shows on the invoice. Shortly after, the equipment goes out of order, most often the lamps. Thus, the patient who needs it is sent to a private clinic to run the test paying a certain percentage hereof, although all medical insurance payers should benefit for free from these investigations.
Nicolaescu: "I am not Jeni!"
Minister Nicolaescu, when contacted by phone by ZIUAnews reporters to talk about the healthcare system and about his nickname Jeni, told us: "Who? I have no idea, it is the first time when I hear it. I have never heard this nickname before, you must have been misinformed."
Political manoeuvres worth EUR 14 billions
Doctors are manipulated into protesting in public. The SANITAS leaders have been playing a double card for years. They threaten blocking the healthcare system, just to put some pressure on members of the Government according to Nicolaescu's wishes, while they grant the current Minister of Health diplomas certifying an excellent collaboration.
Should the doctors' intention to start a strike be real and not manipulated at the discretion of the union leaders, after years of unfulfilled promises the doctors would continue the strike. Let us not forget that older strikes started by doctors during previous terms of Nicolaescu as Minister of Health were stopped after promises were made by officials which remained unfulfilled to this day. The doctors working in hospitals have the same work conditions, hear the same promises and see the same money flowing on private channels for 20 years.
The press recently discovered a hospital of terror after a surgeon with 20 years of practice behind him allegedely got tired of the work conditions in his hospital. Dan Oprea, surgeon, admitted that he has put his patients' lives at risk for 20 years because... that is how the system operates. He failed to explain why he did not come out at the first or second malpractice allegation. He blamed not the Minister of Health for his work conditions but the hospital manager and Doctor Raed Arafat who had allocated too much money for SMURD and not enough for hospitals. Although allegedly upset for the work conditions in hospitals and aware of the thefts happening in the healthcare system for years, Oprea failed to give the name of the person who stole the money meant for the hospital where he works. Oprea did not ask anything, he simply said out in the light things known by people for years. A media scandal broke out as if Oprea's information were new, forcing Minister Nicolaescu to take a sudden decision: he sent Raed Arafat to Ploiesti to investigate the cause, the very person whom Oprea had accused of allocating too much money for SMURD.
"My name is Oprea Dan and I am a surgeon at the Prahova County Emergency Hospital, also known as "hospital of death" or "hospital of terror" by the local community. As one of my colleagues said, I am embarrassed to even say where I work. (...) Beyond all the people who run this hospital, there are so many others who sacrifice themselves working here! Not all of them waste their time reading newspapers, as recently said by a former accountant turned into healthcare specialist overnight. The Romanian medicine has depersonalized. Whether this is good or bad... time will tell. (...) There are no funds for anything. An ethylene-oxide sterilization equipment has been unused for over a year and has not been fixed, although the engine to repair costs around EUR 2,000. We are forced to perform dozens of surgeries with the same single-use electronic scalpel, we hardly ever have atraumatic needles, having to use threads invented during Doctor Andreoiu's time. (...) It is frustrating when antibiotics in the hospital pharmacy are different from one day to another. If we prescribe a blood-thinner, the day after we must change the prescription, although it is clearly a malpractice case. Forced to make compromises and live with bugs in patients' rooms, we see outdoor restoration works useful only to those who order them. I no longer understand. (...)
Reform! EAU, SMURD, war flags, festivities, heroes. Raed Arafat, saviour of the Romanian medicine? Let me ask as an old and stupid surgeon, otherwise I would have been working abroad by now, is the victim of a terrible accident, rescued by the SMURD and later EAU, already in full health? Who and where treats and saves that patient? He is treated in the HOSPITAL, of course!
I wonder then, why does the reform never go beyond the hospital doors? Why is this essential part of the healthcare system constantly neglected? The SMURD founder, if he is able to, should close the circle and only then can he be called the saviour of the Romanian medicine! (...) The managers of large hospitals and clinic are able to obtain funds through their relations and influence. What happens to a small county hospital like ours, that presents no interest for our superiors? (...) There appeared a man who ran financial and accounting analysis, convinced that he knew how to solve a problem, but he simply depersonalized the patient, concealing him behind a pile of papers. And this man calls himself a Liberal... what a mockery, good just for the Minister of Finance who has less wages to pay! Should one really want to help this hospital out, a hospital that belongs to the local community, do not force it to close down! Try to see, to know the reality seen by the many and ignorred people, not the reality presented by those who move papers and statistics from one office to another, who sold themselves for little money and retained dark interests."
The robbery X-ray
The proof that Doctor Oprea's allegations are not new and that he is simply used as a minor player to force a major financing of the healthcare system is represented by numerous scandals that broke out in the media on the overpriced or useless purchases of medical equipment. One of the most common methods is the purchase of very expensive equipment - like a NMR or an angiogram- that goes out of order in a few months, the explanation being very simple: although the price paid through the public purchase system is for a new piece of equipment, the actual equipment that is sent to hospitals is used, with used parts, going out of order after a few months of use. Thus, the hospital not having the money necessary for mending the equipment, nor the Ministry of Health, the hospital or clinic signs, on behalf of the patients who need such medical tests, an agreement with a private clinic, usually close to the state hospital managers.
In some cases, the private clinic that provides the services needed by hospitals with out of order equipment are located within the state hospitals. The private clinic is paid directly by the patients or, in case they are referred to the private clinic by their MD, the money is paid by the public medical insurance agency. Part of the money eventually goes to the person who signed the agreement, the amount being overwhelming.
One of the cases that became known to the public involved Doctor Serban Bradisteanu, who bought medical equipment worth EUR 9 millions for the penitentiary healthcare system. In his capacity as Chairman of the Public Bid Committee, Bradisteanu favoured a Swiss company and an Austrian company. Investigators discovered that, in exchange for his medical "performance", Doctor Bradisteanu was paid almost EUR 4 millions. Despite the market-breaking bribe for which the National Anticorruption Department prosecutors ran an investigation, Bradisteanu was acquitted and the money never seized, the case being retrialed at the moment.
Useless medical equipments and materials
Another example was the purchase of extremely expensive medical equipments worth EUR hundreds of thousands which later deteriorated because they had never been used. One of the scandals referred to the purchase from abroad of several modern sterilizing equipments at the end of the 1990s, while the number of patients infected with Hepatitis or HIV was increasing. Although the Government at power at that time used a USD 500 million loan to pay for the equipments, they remain unused to this day, stored in various hospital basements. The reason is already too known and too often used as an excuse: there are no appropriate rooms to install them and there is no money for their maintenance.
The Timisoara Institute for Cardiovascular Diseases, for instance, spent EUR 1 million for a single piece of radiology equipment that has never been used and is now covered by dust. Similar examples are found in hospitals in Sibiu County, Brasov County or Bistrita County, where laboratory equipment has been purchased but never used, because there were no funds for maintenance works or additional materials.
Another common practice in many public hospitals is the purchase of cheap, low quality and overpriced medical materials, paid by the same public medical insurance agencies out of taxpayers' money.
Medical tests run with reactive substances past their expiration date
Medical testing laboratories represent an important income source for the "smart boys" in the healthcare system, as Romanians' health constantly deteriorates.
A patient who wish to run the same medical test in two different laboratories may be unpleasantly surprised of receiving two different results, because certain laboratories use low quality reactive substances or even past their expiration date, the chemical tests being run in blind. If the test results are not correct the diagnosis will also be inaccurate and the treatment quite useless. The common patient will have to repeat all the tests when the first treatment does not work, usually in private clinics where complex, expensive and most often useless tests are recommended. The private medical laboratories that have concluded agreements with the public medical insurance agencies are paid by the public insurance budget, in addition to charging the patient.
A number of patients have filed complaints with the patients' associations in recent years, claiming erroneous diagnosis have been set based on laboratory tests' false results.
Grants and rewards for doctors
A barely legal practice is continued by the medicine producers, offering doctors grants and rewards like exotic trips, paid trips abroad to congresses and events as a sign of appreciation for prescribing their products. These expenses are deducted by the pharmaceutical companies from their taxes as sponsorships while the Romanian citizens unfortunate enough to be in the position of seeing such doctors continue taking medicines that are often not necessary.
In West European countries the percentage of the prescribed expensive medicines is significantly lower than the percentage of generic drugs (that contain the same active substance) that are much cheaper. However, that is not the case in Romania.
Doctors prescribe the branded products in return for the bribery paid by the pharmaceutical companies, often taking the shape of a sale percentage.
Ionel Blanculescu, former Minister of Health, ordered an audit on the healthcare system between 2003-2004 and is now able to explain the situation. Blanculescu estimates that the Romanian healthcare system loses almost EUR 500 millions because of the excessive branded medicine use. "The pharmaceutical companies are the true puppet master for years, supported by high officials in the healthcare system, the heads of the 50 committees in the Ministry of Health who decide the medicines to be subsidized or prescribed as free. Therefore, the pharmaceutical giants manage to achieve more than USD 45 billions per year in turnover", Blanculescu said.
The National Health Programs - the money box
Incredible amounts of money are spent through the national health programs originally designed to support the patients with chronic diseases like cancer, diabetes, TB, HIV-AIDS. These programs are financed by the National Medical Insurance Agency. The lack of precise information on the exact number of patients suffering from the above diseases allowed the development of a medicine mob.
One of the best-known scandals in the field concerned the "Insulin" Network that developed and worked for 13 years. More than 9,000 prescriptions were written illegally by doctors affiliated to this network, the greediest being Doctor Tiberiu Mogos, a well-known endocrinologist of "Parhon Institute", who set up an EUR 500,000 business with public money and who gave 600 prescriptions for one patient with the support of several pharmacists, thus causing a LEI 2.1 million loss to the state budget.
ZIUAnews presents below some of the manoeuvres carried during Eugen Nicolaescu's mandate, bleeding EUR millions from the Ministry of Health for various programs or towards companies indirectly related to the Minister of Health. The same Nicolaescu currently prepares to pay more than EUR 200 millions for medical tests of the population, after EUR 170 milions were paid in 2007 to assess the Romanians' health condition.
More than EUR 200 millions will be spent on testing the health condition of Romanians, at the recommendation of Minister Nicolaescu, after the National Program for Health Condition Assessment started in 2007 and which cost EUR 170 millions proved facts like: the death risk increases gradually by age and that drinking affects liver. "Out of the 10 million Romanian citizens assessed during the program, 20% are smokers. Men smoke twice as much as women with younger people smoking significantly more than the elderly and more in the urban areas than in the rural areas", the Minister said.
The alcohol consumption percentage reaches 16%, five times more men than women and twice more in rural areas than in urban areas. The main diseases people suffer from are cardiovascular diseases, diabetes, cirrhosis and cancer. More than 40% of the scanned Romanians present the risk of cardiovascular diseases, statistics information alredy known. The Minister of Health reminded that the main role of the program is to prevent further diseases, bringing up a Eurostat poll of 2008, ranking Romania among the first European countries in terms of money allocated for prevention. During the program 10,778,868 medical tests were run (50.1% of our country population), thus discovering 5,747,598 risks in 4,434,763 individuals (35.7% of the persons whose health was assessed).
The IMF, new escape goat
Minister Eugen Nicolaescu announced at the beginning of this month that a set of bills on the Romanian healthcare system reform has been finalised and is now open for public debate, referring to it as the set of basic medical services proposed by the Ministry of Health and free to all citizens, either insurance payers or not. The new law will drastically reduce the public hospital admissions, the number and duration of medical appointments to which patients are entitled. In other words, less services will be provided to the monthly insurance premium paying citizens and more rights will be granted to those who fail to pay the insurance premium. Structured on several chapters, the set of basic medical services targets primary healthcare, ambulatory care, hospital system, community healthcare and dental medicine.
The set of essential medical services will comprise emergency care, prevention services, primary care, ambulatory appointments, laboratory tests and imaging tests. According to the Minister of Health, this bill targets the resource optimization and is the first document of the kind adjusted for the 2014 budget, the entire package being "a political committment" stipulated in the IMF agreement.
The "Vaccine" Scandal
The Ministry of Health budget lost significant amounts of money in the "Vaccine Scandal". The public bid winner was a company known as close to Minister Nicolaescu, SC A&G MED TRADING, whose object of activity was pharmaceutical products wholesale. The amount paid by the Ministry of Health in 2008 for the import of 370,000 Priorix vaccines (combination vaccine against measles, mumps and rubella) was close to EUR 2 millions. A&G Med Trading is a regular of the trade agreements concluded with the Ministry of Health, having tens of commercial agreements worth hundreds of thousands each, the most profitable of them concluded directly with the Ministry. The company is currently owned by a Cyprus-based offshore, Masterpharm Invest Limited with 99.6% of the shares, Georgeta Cristea with 0.033% and Adrian Filip Cristea with 0.0293%. When the vaccine agreement was concluded, the Department for Pharmacies in the Ministry of Health was run by Mariana Iordache, Georgeta Cristea's sister. Mariana Iordache's husband, Niculae Iordache, was the brother of Sorin Iordache, former Personal Advisor to Minister Nicolaescu. Sorin Iordache's wife, Marcela Iordache, was running at that time the HR Department in the Ministry of Health.
EUR 200 millions - this will be the price tag for a new assessment of this nation's health
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