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October 23, 2021

Health system crisis

After a promising start, the debates on the new Health Law are at a dead end. And that’s not just because of the increasingly acute and more frequent political rows. Insufficient financing is the main obstacle in the way of projecting optimal solutions within the health system. This is not due solely to the far too small GDP share allocated; it is also due to the fact that this share is often used erroneously. And that is because an abyss has appeared between the medical activity per se and its organizational, managerial structure. The selfish, illegal interest acts as a noxious factor. That is how one can explain why, while solutions for enhancing the efficiency of the health system are debated, a special institute of international prestige such as the Cantacuzino Institute in Bucharest is struggling to survive. The Cantacuzino Institute has earned international prestige in high-end domains such as the production of serums and vaccines ever since the first half of the 20th Century, including by annihilating or preventing epidemics that ravaged other European countries.

During the two World Wars that Romania took part in, but also during periods of infectious chronic diseases, the serums and vaccines produced by the Cantacuzino Institute saved a lot of lives, including the lives of newborns. Newborns whose deaths now place Romania on a painful first place in Europe when it comes to infant mortality, also because of the fact that the prestigious Cantacuzino Institute was pushed towards the precipice by political leaders in the last two decades. Before 1990, over 1,400 researchers were working within the Institute and their professionalism was recognized throughout Europe, including through the massive export of serums and vaccines. Today, given the complete under-financing of the Institute, the number of researchers dropped drastically, the Institute’s technological procurements have thus become impossible and, as a consequence, vaccines can no longer be produced. Since 2009 the Cantacuzino Institute has survived thanks to financial donations from admirers. Admirers that the current economic-financial crisis has kept driving into poverty so much so that today the Cantacuzino Institute is left without any support. And all the vaccines that Romania needs are imported. But since the price of these imports massively rises, the Romanian state increasingly finds itself unable to buy them to the extent of internal needs. The result? Mortality is ever growing not only among infants but also among elderly Romanians. To the unconfessed, yet obvious satisfaction of former Romanian prime ministers who were indignant with the fact that the number of retired people keeps growing while the number of tax-paying employees is continuously dropping under the pressure of unemployment. That is precisely how one can explain the fact that the average lifespan is dropping in Romania, while in EU countries it stands at high levels. The serious health problems that the Romanian population faces return at the forefront of election campaigns every time. And that is because, among other things, being ever more numerous and somewhat better organized, pensioners increasingly matter in the outcome of elections. That is why during electoral periods such as the current one, a veritable war starts between government forces and opposition forces, including over the pensioners’ state of health. An increasingly precarious state of health since the Romanians’ pensions are extremely low compared to European levels and especially compared to the daily cost of living. That is why the pensioners’ “investments” in their own health are very modest. All opinion polls reveal that only a quarter of Romanians affords spending more than approximately USD 10 per month on pharmaceutical drugs. And less than half the Romanians afford paying the maximum price of an optimal treatment recommended by doctors.Likewise, dramatic situations for the state of health in Romania can also be explained through the very high price of imported pharmaceutical drugs. Why are foreign pharmaceutical drugs dominating the Romanian market? Because, as the current state of the Cantacuzino Institute shows, the local pharmaceutical industry was completely neglected in the last two decades. Precisely in order to be sold off through fraudulent privatizations. Thus becoming part of foreign companies’ patrimony. Those are precisely the companies that today juggle with the price of pharmaceutical drugs, as they wish. This dictatorship of prices is made possible by the support given by some Romanian state authorities that find themselves in an obvious conflict of interests. Older or newer revelations show that some of the “officials” that regulate the prices of pharmaceutical drugs are covert shareholders of various companies engaged in distribution, trade and service activities in the pharmaceutical sector. That is how the prices of pharmaceutical drugs grow continuously. And that is the source of the masked opposition towards reform initiatives within the health system, including towards the Health Law. The amplitude of such maneuvers that seek to continuously hike the prices of pharmaceutical drugs is so high that some historians state that Romania became an EU member only after its internal, national production, including the production of pharmaceutical drugs, collapsed and the country thus became a huge and profitable market in which the producers, importers and distributors of pharmaceutical drugs act solely in their interest. Sometimes they compete against each other, resorting to mutual attacks that go as far as undermining the prestige of some pharmaceutical drugs. Afterwards, the same companies act jointly in order to hike the price of the same pharmaceutical drugs. That is why the Competition Council, otherwise excessively “lenient,” was nevertheless forced to fine, from time to time, some distributors that acted jointly in order to hike the prices of these products endowed with maximum social importance. Discrimination in the health system has thus become a daily occurrence in Romania. It grew worse following the former Boc Government’s decision to shut down 67 hospitals that were suffering precisely because of the same government’s budgetary discrimination. The protests that followed were very strong. Precisely under their influence, the current health minister decided to reopen some of the aforementioned hospitals. Unfortunately, the lack of medical staff is a difficult obstacle, but not impossible to overcome. When it is known that today, for the first time in its history, Romania’s population is dropping during peace time, no effort is too great when it comes to improving the general state of health.

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