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Albanian health between "German" and "American"

2023-08-01 15:23:00, Opinione Erion Dasho

It has been over twenty years that Albanian doctors have turned Germany into a target for building a dignified and well-paid professional career, while in the last ten years this trend translated into several hundred doctors leaving every year.

The Ministry of Health found no other solution (certainly due to its own short-sightedness and incompetence) other than holding the diplomas of young doctors hostage. How much this measure will affect the hemorrhaging of white shirts remains to be seen, but personally I think its impact will be negligible.

Meanwhile, the situation inside the country has worsened in another direction. The private health structure known as the American Hospital continues to employ the cream of Albanian medicine, attracting them from the public sector.

At the beginning of this hospital's journey, the fashion was dual employment, where doctors used the public sector to provide a referral base of patients. This approximation has now been replaced by full-time employment near the private structure.

The salaries for the vast majority of doctors are, if not similar to the salaries offered in the West, at least dignified for the Albanian labor market. Even the working conditions have been constantly improving, where "American" doctors do not lack either equipment or medications.

This has led to the emergence of several phenomena that must be carefully analyzed.

First, due to the departure from the public sector of luminaries and well-known doctors in the middle of their careers, a number of very important services have already become exclusive to the private sector. A typical example was the brain intervention performed by the actor Fuga. 10 years ago, this intervention was carried out at the "Mother Teresa" QSUT; not today anymore.

Secondly, some centers which in the vast majority of countries of the world function primarily near public structures, in our public hospitals are rapidly atrophying. The Stroke Center, which has as its object the treatment of cerebral hemorrhage and brain infarction, was launched with fanfare at QSUT by Borat and Minister Beqaj in 2017, but today it has been surpassed in quality and the range of services it offers by competing centers in American Hospital.

Thirdly, the departure of still young doctors, but with consolidated professional experience (doctors aged 45-55), deprives QSUT of the opportunity to offer complex and innovative services and turns the American Hospital into a monopolistic provider of these services. . Examples are the cochlear implant and the kidney transplant, which were also first performed by American Hospital teams.

Not blaming the private sector for the state's failures, the American Hospital should be congratulated for at least offering these services to patients in Albania.

However, the issue of payment should not be forgotten. When these services cost tens of thousands of euros, they turn into "catastrophic" expenses that force families to go into debt or sell family assets such as houses, land, etc. For the families of the vast majority of patients, even these "solutions" are not options, effectively sentencing the patients to death.

At the moment when life-saving services are provided exclusively by the private health structure (whether it is the fault of the state or the merit of the private), the state has at least the obligation to purchase them on behalf of the patient.

Regardless of where the renaissance has led the system, the principles of social health care, solidarity and free provision at the time of need still stand at the basis of the Albanian health system (this should not be confused with the demagogic and deceptive slogan of the renaissance for "free health").

It is the duty of the Mandatory Health Care Insurance Fund (MFSDKSH) to identify, cost and contract these services on behalf of the patient, in order not to create gaps of inequality and discrimination.

Especially in the case of cardiac and cerebral emergencies. Regarding these two, in the English language it is said "time is brain" or "time is brain". Every minute that passes causes nerve cells to die, and there comes a point when the person is headed irreversibly towards death or permanent disability.

If this delay comes as a result of objective causes, it is painful but acceptable. If it comes because the family members of the patient, whose brain is losing cells by the minute, have to collect the necessary money before starting the life-saving treatments, this is criminal and reprehensible from the ethical and deontological point of view.

Finally, when the private sector becomes the sole provider of certain services, it has, in addition to the right to be contracted and paid with public money, also the obligation to provide them with high quality and standards.

This means accountability and monitoring by the regulatory structures of the Albanian state, not only of the type of inspectorates, but also of centers such as Quality, Safety and Accreditation.

Just as private hospitals publish in their marketing materials testimonies of patients satisfied with the quality of services, there are of course also testimonies of patients who received poor quality services, up to patients who lost their lives, where family members blame the low quality of the service .

These days, a painful story brought to the attention of the family members of a patient has circulated on social networks. This testimony should definitely be followed by the regulatory and accountability structures, because the family members of the deceased raise some sharp problems that cannot be ignored.

In conclusion, due to screaming incompetence, short-sightedness and, perhaps, even corruption (at least moral), renaissance health has lost the battle not only with the "Germans" across the border, but also with the "Americans" in Albania.

The public health sector is gradually atrophying, while the private sector is strengthening every day by filling the gaps and exploiting them to position itself in the market as a dominant, even exclusive, provider.

It is the duty of the Ministry of Health and the FSDKSH to regulate the provision and financing of these services.

Albanian citizens who pay millions of dollars in salaries to these incompetents have the right not to die waiting for their family members to collect the "blood, heart, or brain tax"...