In the past 25 years, the Romanian government has provided numerous poor management examples of the assets it’s responsible for: state-owned enterprises incapable of reinventing themselves after 1989 and ending up shut down, companies with good potential or a very good financial position which got ripped off under the eyes of shareholders only to be sold for peanuts, and the list could go on. The worst part is that, before falling under EU laws, a huge amount of money had been injected into these companies in the vain hope of turning them around and keeping them afloat. The whole process either failed or, once successful, they saw their profits diverted back to the private sector.
In the end, willy-nilly, the bulk of Romanian companies either went under, or were privatized, and the ones still standing are struggling to keep up with competitors and private minority shareholders breathing down their neck. There is, however, one behemoth state ”company” in which it continues to constantly pump money without any ability or interest to check the effectiveness of how the money is actually spent. Or, better still, to make sure that this company is well sheltered from the competition coming from those capable to put that money to much better use.
This „company” is the public healthcare system.
It puzzles me to see how all governments have poured so much money into a system of vital importance convinced that it will be able to spend it effectively despite all evidence to the contrary. That would have been a miracle! They would have managed something uprecedented! That a government-owned company in a position of near-monopoly in relation to receiving public funding, to be able to reform and become competitive. Sadly, miracles are hard to come by nowadays. For that reason, the sooner they acknowledge that the public healthcare system cannot be the exception of the last 25 years, the less public money will be spent on questionable purposes.
On the other hand, the private healthcare system continues to fall short of the critical mass that would allow it to develop the complexity of medical interventions. The result is that, for emergencies or complicated interventions, patients have only the public system to go to, with the associated risks. The lack of competition on these services is all but guaranteed. If the state’s health insurance department was interested in the proper management of taxpayers` money then it should be the first one to wish to encourage healthcare competition.
Especially given that the rapid aging of Romanian population will put unbearable pressure on the public pensions system and the public healthcare system alike. But whereas there (still) is a private pension system to offset the predictable drop in public pensions, the healthcare system continues to see almost all public money being allotted to financing it. This project cannot end well keeping in mind the sharp rise in the number of the elderly population. The only solution is to have an approach that replicates the private pensions system whereby part of the taxes is put into a private management system. It has already proven its success as far as pensions were concerned.
My private health insurer wrote to me the other day the following message: „If healthcare providers make incorrect claims, it can lead to extra costs that then increase premiums down the line – something we’re very keen to avoid. That’s why we’re vigilant in our fight against fraud. We constantly work to protect our members from fraud by: monitoring invoices from healthcare providers to ensure they’re genuine, checking that the treatment we’re paying for is the treatment you received, making sure that treatment we pay for is medically necessary and correct”.
Do you see the Romanian state doing the same with incoming invoices from the medical institutions owned by itself?
Have a nice weekend!
