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December 9, 2022

Poverty equals disease

A recent study conducted by the Research Institute for Quality of Life in Romania brings back into public limelight the finding that the great majority of Romanians live in poverty. Many rural families lack electricity and tap water, have makeshift bathrooms, and most of them have but backyard toilets. The means for transport and public transport leave a lot to be desired, and that, while the number of Romanian car owners is much lower than the EU average. And, as known, poverty is instrumental to disease. The number of hospitalized patients is growing by the day, mostly from among the children and the old. For many years now, Romania has been ranked painfully high as to infant mortality EU wide. About 2500 infants die annually. And such “performance” continues throughout all age groups, given the high frequency of cardiovascular, kidney and bronchopulmonary diseases, diabetes, and even AIDS. The Romanian medical staff emigrating abroad is beyond comparison with that in any other European country. Given such circumstances, what would the upcoming flu epidemic forecast  bring?

The health sector in Romania has long been struggling to survive, with underfunding being one of the chief reasons for its decline. Over the past 18 years, the Growth Domestic Product rate allotted to Health has wavered around 2 pc, and lately, it stood at circa 4 pc, without any noticeable administrative improvement. Among others, because funding often reflects the political hue of counties and hospital managers, and not the constitutional imperative of the equal access to health by all citizens of this country. This fund inequality is at the root of some hospitals lacking medical equipment and medicines, which unless closed down, provide some sort of social rather than medical assistance, as most of the sick, old and very poor, whose children have left to work abroad, have nobody to take care of them.

All these shortcomings makes saving the Romanian health system imperative. However, an optimum solution calls for thorough preliminary studies. A poorly prepared reform transforms itself into its opposite, as it happens today when patients are but mere statistical figures. Government officials find excuses for their mistakes, blaming previous governments for their failure to reform a system that has been deficient for over 15 years. Justified as pointing the finger at past governments might be, it nonetheless does not excuse the current errors that are at least as serious as those of the past. As his predecessor did, this minister of health made great fuss over hospital decentralization by subordinating them to local administrations, only to later on “realize” they lacked the necessary funding, which led to many hospitals being closed down, ignoring the fact that some of those authorities had the financing means after all.
Why then shut down hospitals if local administrations pledge to fund them accordingly? Mayors are taking such efforts since patients would have to travel for tens, and sometimes hundreds of kilometres, to reach a hospital that is still operating. Could the health minister say the ambulance system is comprehensive enough to allow patients’ quick access to hospital? And if so, could ambulances reach those patients in appropriate time? Is the road network good enough to satisfy such demands?

Yet, health ministers don’t look that far, as they are the prisoners of the here and now, of their concern with how to enrich faster the political clan to which they belong. Many of the hospitals closed down amassed piles of debt exactly because they were pushed by local magnates into shady tenders aimed at procuring overpriced medical equipment, medicines and food. In many places, including Timisoara, Sibiu, Brasov and Bistrita, expensive laboratory equipment was procured, only to remain unused from lack of staff able to operate it, or maintenance money. The origin of such lucrative practice for local clans could be traced back to the 1997-1999 when a USD 50 M government credit was spent on very expensive sterilizing equipment left unused and consequently deteriorated.

When questioned about such errors, government officials manipulate the truth as their interest dictates them, which is opposite to the national-strategic interest. This explains why, during the term in office of some health ministers members of the Democratic Union of Hungarians in Romania, the hospitals shut down were located predominantly in southern Romania, where the Magyar population is all but non-existent, and much fewer in the so-called Szekler land. Given such “auspices”, little wonder that the medicine Mafia would not allow itself be upstaged. This explains why Romania imports so many medicines while the Romanian pharmaceutical industry is being torpedoed, with help from the local corrupt, obviously, who make sure that medical prescriptions contain foreign medicines in proportion of over 70 pc, which in turn leads to government officials resorting to increasingly contradicting strategies, among which that demanding a reduction in consumption of free medicines or introduction of the co-payment system in the treatment of some chronic diseases, according to the “reasoning” that “he who wants more must pay more”. Otherwise said, medicine financing for chronic diseases is cut back on account of… such diseases being too many and costing too much. Therefore, mostly the old had better not get sick with so many chronic diseases!

If such aberrant decisions are no longer a reason for ample social protests, as it should, is also because such developments are increasingly frequent. This painful reality is at the root of the following warning: “When you close down a hospital, you have opened a cemetery as well!”

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