There is this man in Romania, who pretty much everyone here has heard of, especially now, but I suspect almost no-one outside of Romania has. His name is Raed Arafat. He is a Palestinian who grew up in Syria (like so many Palestinians to refugee parents), and he came to Romania at the beginning of the 80s to study medicine at the University in Cluj, and then subsequently to the university in Targu Mures to continue his studies. After graduating and going into practice in Tg Mures, and following the revolution he saw the need for a real emergency service. He and a team of volunteers knocked on every door in the city (and I am assured that it was every door, and it's a biggish city) and during a time of great hardship raised enough money in whatever donations people could give - very often very small amounts of money - to start something called SMURD. The story of SMURD is a long and impressive one and it has grown from these very small beginnings to be a vital cog in the otherwise ailing Romanian healthcare system. You can read all about the history of it here: http://en.wikipedia.org/wiki/SMURD
Anyway SMURD eventually became incorporated into the healthcare system, and Arafat became an under-secretary of state for health.
But now a "scandal" (everything in Romania is a scandal) has erupted - Arafat has resigned and left the Ministry because of a new health care law which effectively privatises the ambulance service. Basescu (the president), rather than talking to Arafat - who, I submit, knows a fuck of a lot more about emergency medicine than Basescu - abused him live on TV (via the medium of calling into a chat show), accused him of lying, and the went on about his "leftist views" (in this case not wanting to privatise an essential public service is "leftist", which I suppose it is, in relation to what to me seems like a pretty hard line right wing position - viz the privatisation of an essential public service). Basescu then pretty much told him to resign, which fairly unsurprisingly, Arafat then went ahead and did.
It's a great shame, as he's obviously a deeply committed individual who has done an incredible amount for Romania, and deserves to be heard and not treated like shit by an obnoxious president. I hope SMURD will survive, and I hope the healthcare system survives, but I have my doubts. Basescu and his government seem hell bent on using the excuse of "austerity" to destroy education, healthcare and pretty much everything else that the country actually needs.
You can watch Arafat here giving a speech in happier times through the TED network (in Romanian)
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The scandal was mostly about the emergency system, but the new healthcare law changes a lot more:
- all hospitals are going to be privatized, they'll be either sold to companies or organized as non-profits.
- anyone can start one's own health insurance company (by "anyone" I mean any multi-billion international insurance corporation; it's mandatory to have at least one million of health-insured people across the world, so the local companies are not allowed to do it)
- all residents must choose an insurance company for "basic insurance" and pay the monthly insurance rate. (there are a few exceptions, like children and pregnant women for which the state will pay for it; for employees, a percentage is automatically taken from the salary)
- "basic insurance" includes some medical services, but not everything. The list of covered services is going to be published each year and it's expected to gradually remove from the services. If you want complete coverage, you have to buy an additional (and presumably costly) insurance policy from your insurance company.
- even if you have the "basic insurance" and you're going to use only the covered services, it's not going to be free. You'll have to pay a part of the price, through the "co-payment" system.
- students, pensioneers and housewives are not necesarily covered automatically: for instance, if a pensioneer has an income of over 700 RON (160 EUR)/month, one has to pay for it. If a student's parents are not covered (for instance, they work abroad), one has to pay for it, etc
Thanks Bogdan. I knew some of that but not all of it. It makes me want to throw myself under a bus (while I can still afford to). Unreal. And opposition to this is "leftist".
Basically it sounds more or less like the US system which is so discredited that it's the biggest political issue in the country year in year out. Insurance companies make an absolute mint (except in this case they won't even keep the money in Romania), and the state ends up paying more anyway. It's absolute madness
Oh, and I forgot to mention that the basic insurance will have waiting lists for expensive treatments. If you want to bypass the waiting list, you need to get the additional insurance.
Of course, I suppose the companies can refuse to give you additional insurance if you have a costly disease. The law specifically says that the insurance companies can't refuse anyone for the basic insurance, but after that I guess it's up to the insurance company.
Great blog you have here.
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