In the Parliament of the Federation of Bosnia and Herzegovina, health care is formally no longer in the last eighth place as an item – “miscellaneous”.
Although at the beginning of the year, during the adoption of the budget, it was moved to fifth place, the situation in practice remained the same, which means that it is extremely difficult for the majority of patients.
Oncology patients are still on waiting lists for months for prescribed, life-saving therapy. Unfortunately, many do not welcome it.
A formal move
The list of medicines of the Solidarity Fund has not been changed since 2019, a full seven years. Although the expert commissions have finished their work a long time ago, innovative drugs are still unavailable to patients.
Those in the know say that the List of Medicines is “stuck” in the relationship between the Ministry of Health – Ministry of Finance – Government of FBiH, and the main problem is money that is not there.
It is not there because the FBiH Government violated the FBiH Health Insurance Law this year and set aside 100 million KM for the Institute of Health Insurance and Reinsurance, which, according to financial experts, is approximately 150 million marks less.
But if the money is not directed properly, it will always be missing, says dr. Melika Mahmutbegović, representative in the House of Representatives of the FBiH Parliament.
Therefore, the vertical program of the Solidarity Fund, as well as the entire segment of treatment and allocations for health, require an urgent review in order to identify problems and approach their solution.
– The revision of the vertical program of the Solidarity Fund would show where we have successful therapies and where we don’t, and in which situations we should abandon some treatment protocols and introduce new ones. All this is without clear indicators, a scheme that was inherited – claims Mahmutbegović.
She reminded that due to a lack of money and long waiting lists for therapy, the treatment of certain patients was stopped, after which, as she says, she requested a thematic session of the House of Representatives on healthcare, where all actors, on the one hand patients and users of services, and on the other the Federal Ministry of Health and the Institute of Health Insurance and Reinsurance, would express their views and problems.
– The session was supposed to be held on May 25, but it was postponed for private reasons – adds Mahmutbegović.
She noted that the Federal Institute has huge funds at its disposal, but they are still missing.
– That’s why we need an audit that would give an answer – why is this happening? Regardless of allocating huge amounts of money, patients are still dissatisfied. With a reason, because imagine how it feels for a person who urgently needs therapy today, but cannot get it. He is on the waiting list, and he is destined to die in a few months because he does not have adequate medicine. Those are terrible things, what does the waiting list mean to someone who has a malignant disease – asked Mahmutbegović.
According to her, moving health care from one place of priority to another does not mean anything to patients if they did not experience improvement in practice.
– Something is not right in that chain, and the patients as well as the general public should have received an answer at the thematic session. The situation has changed in terms of treatment, therapy, protocols, but also the commissions that approve it. We want to know – who approves a treatment protocol? These are unknown to us. We have a situation where someone approves a treatment protocol that is too expensive for a certain disease, and on the other side you have that the treatment with therapy was successful, but it was not approved – emphasized Mahmutbegović.
Moving health care forward in the ranking of priorities is a formal move by the FBiH Government and nothing else, says representative Alma Kratina.
– What we live in reality is something completely different. I will compare it with the new Law on protection against domestic violence. If the Government did not pass the implementing acts that it should have passed within a certain deadline that has long passed, what does that mean for us? We have so many phenicides, and we don’t have the tools that the new law provides, because we don’t have bylaws. The address is the executive power, that is, the line ministries. The same situation is in healthcare. The Federal Ministry of Health is a passive body, and almost no one has ever seen a minister in Parliament. The situation is the same with the Board of Health, even though there are so many doctors. I think that in general they did not put pressure on the Government, because most of the members of the Committee are from the ranks of the majority, so everything is clear to us – says Kratina.
Given that the pre-election campaign has begun in earnest and the annual vacations are coming, it is unlikely that anything will change for the better for patients, the representative adds.
– From the state to the canton, our institutions are trapped by irresponsible policies. When we talk about the federal level, non-governmental organizations very often took the lead in protecting the most vulnerable categories of citizens in their care. They were the ones who, through representatives who have sensibility in the legislature, “pushed” certain legal solutions and changes that would contribute to better patient protection. Domestic violence is a plastic example. You can see how much pressure there is from non-governmental organizations, and they do the same in associations that bring together patients, constantly emphasizing that at least oncology patients should be protected and the issue of financing the Solidarity Fund should be resolved, which was never heard to be resolved in the right way by the FBiH Government – said Kratina.
No significant changes
Delegate in the House of Peoples, prof. Ph.D. Fatima Gavrankapetanović-Smailbegović says that even after four years of mandate, the authorities failed to achieve significant changes that the citizens of FBiH would feel as a real improvement of the health system.
We still face long and exhausting waiting lists for diagnostic procedures and surgical procedures, he says. Still, a large number of the most serious patients do not have timely access to therapies, and oncology patients, suffering from rare diseases, pulmonary hypertension, Duchenne’s muscular dystrophy and numerous other serious diseases, fight every day, not only with the disease, but also with the system
– The fact that even in this mandate the Solidarity Fund has not been financed to the extent prescribed by law is of particular concern, which is why the problem of unavailability of medicines has been deepening for years and waiting lists are getting longer. Additional concern is caused by the case of a closed polyclinic for in vitro fertilization, where close to 400 embryos and other biological material were left without clear information about the status and method of preservation. The most difficult thing is that families who put their trust in the health system and in their struggle for parenthood still do not have the answers they deserve. This tells us in favor of the fact that it is unacceptable that there is not a single IVF center in the public health system in the entire Federation – emphasizes Gavrankapetanović-Smailbegović.
He believes that the healthcare system has been a place of uncertainty and waiting for the past four years.
– We have excellent doctors, hardworking and dedicated nurses and other health workers, but the entire system does not function as it should. Unfortunately, during this period we witnessed almost daily appeals from patients who had to seek help for their treatment through the public and humanitarian actions. The fact that with more responsibility, good will and timely action of the competent institutions, a significant number of those patients could have been treated in Bosnia and Herzegovina, with their families and with the dignity that every human being deserves, is particularly painful. My opinion, as well as the opinion of many others, is that huge amounts of money are poured into the public health sector, but the health service is not even close to what the citizens deserve – pointed out Gavrankapetanović-Smailbegović. Factor.
