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Health care cash arrives just in time

The national Pharmaceuti-cal Chamber (SLK) decided not to demand cash payments for partially subsidized drugs after the government approved a financial injection into the troubled Slovak health care sector on September 2. But the chamber warned it had only postponed its cash-for-drugs plan until the next session of government, scheduled to be held after elections on September 29.
Prime Minister Vladimír Mečiar's government agreed to extend 1.1 billion Slovak crowns (Sk - $33.5 million) in several tranches to the health care sector. But SLK spokeswoman Marta Slezáková argued that the real sum effectively going into the system would be only 470 million Sk ($13 million), of which the pharmacies would actually receive only 26%. It was not enough, she said, to cure the long-term ills of the health care sector.

The national Pharmaceuti-cal Chamber (SLK) decided not to demand cash payments for partially subsidized drugs after the government approved a financial injection into the troubled Slovak health care sector on September 2. But the chamber warned it had only postponed its cash-for-drugs plan until the next session of government, scheduled to be held after elections on September 29.

Prime Minister Vladimír Mečiar's government agreed to extend 1.1 billion Slovak crowns (Sk - $33.5 million) in several tranches to the health care sector. But SLK spokeswoman Marta Slezáková argued that the real sum effectively going into the system would be only 470 million Sk ($13 million), of which the pharmacies would actually receive only 26%. It was not enough, she said, to cure the long-term ills of the health care sector.

"Look at the debts, which now total around three billion crowns, and then look at the sum that the pharmacies will get, which is around 26% of the 470 million Sk that will actually go to the sector," said Slezáková, who replaced previous chamber spokesman Jozef Blahovec on September 7.

"It could be considered as a first step towards stabilization of the critical situation in supplies of drugs, but the approved measures are insufficient to overcome the problems that we have," Slezáková said.

Finance Minister Miroslav Maxon explained to journalists at a September 3 press conference that "Slovak health care has skillful world-class specialists, hospitals work with the top diagnostic equipment, and Slovak health care uses the best, but most expensive, drugs in the world. Naturally these facts create tension between demands and resources."

The SLK said in a statement that it had appealed to the Ministry of Health Care to guarantee that the extended funds would be distributed to public pharmacies as soon as possible. The Ministry's response to the request was not available.

The protracted financial crisis in Slovakia's health care sector intensified in mid-August, when the SLK warned that it would demand cash payment for so-called second-category drugs from all customers unless the government provided financial help to the health care sector.

The second category of drugs, partially subsidized by the state, includes around 40% of all pharmaceuticals used in Slovakia, but does not include vital medicines such as insulin or substances needed to treat cardiovascular diseases. The pharmaceutical chamber also demanded the state pay what it owes to the state-owned General Health Insurance Company, which could then fulfill its financial obligations to pharmacies

The Health Care Ministry and the Association of Health Insurance Companies have said the demand for cash payments was illegal because the Slovak constitution gurantees the right to medical treatment free of charge to all citizens.

Though the immediate danger of cash payments at pharmacies appears to have been averted for the moment, much remains to be done to revive the ailing health care sector. Opposition politicians and medical experts say that a thorough revision of the health care insurance system and state subsidy programmes will have to be carried out to ensure longer term improvement of the sector's financial situation. But solving the painful health care problem will now have to wait until a new government is formed after the September general elections.

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