EDITORIAL

The crisis of medicines accuses

The winter holidays of 2013-2014 amplified the medical emergencies and some politicians blame it on the fact that, usually, at this time of the year the medical rigors of food consumption are no longer observed. So, in such moments, Romanians “eat in excess, many things and all kind of food.” The explanation is typical politician hypocrisy, because of its absolutist character that places it outside any nuances. It ignores the fact that the poverty which hit Romania affects over 50 pc of the population, that there are social categories which – as the media show us – eat what they find “useful” in trash cans. And an increasing number of children see a chocolate for the first time only on the occasion of donations that are made during winter holidays. What should we say about the old people immobilised in foster homes, who peacefully await their death.

No, the frequency of medical emergencies continuously increases not because of the excessive and uncontrolled food consumption, as our rulers believe! The real causes pertain to the policy enacted by the governments of all doctrine orientations and exclusively refer to a strictly selfish interest. Among these causes, alongside the large-scale poverty, there is also the recent government decision that the medical treatment is mostly granted in ambulatory conditions. The present crisis of hospitals, with the more and more acute lack of medical personnel caused by its massive emigration and the insufficient amount of medicines and number of beds needed even for medical emergencies, all of these represent the real causes of the fact that Romania has the highest incidence of child illness and mortality, as well as general mortality.
From this perspective, the recent “salutary” solution about the enforcement of the predominant ambulatory treatment amplifies the crisis of the health state in Romania. Because the majority of those who need medical treatment no longer resort to a physician, as long as mandatory co-payment has been enforced even for this medical consultation. Each patient must thus treat himself on his own, by going to a pharmacy. Whose number, per 1,000 inhabitants, is 2-3 time higher than the European average. This numeric explosion of pharmacies is explained through the fabulous profits obtained by Europe-based pharmaceutical producers from their exports to Romania. And these fabulous profits of medicine exports to Romania are, in turn, explained through the fact that the politicians who now “deplore” the health state in Romania are the same, in terms of political orientation, as those which destroyed the national pharmaceutical industry through fraudulent privatisations or by accepting the orders from abroad to liquidate this pharmaceutical industry under the pretext of it being obsolete.
This is the reason why the large majority of medicines sold by our pharmacies are produced abroad and their long-term effect is not very well known. But for such pharmacies placed – most of them – under the control of non-specialists it is not the medical effect that matters, but only the sale price of the product. The obsession of the price explains the fierce competition between pharmacies, with an abusive and contradictory advertising that puzzles the buyers and cultivates the confusion between authentic medicines and simple cosmetics. This abusive treatment of the customer is also stimulated by the fact that many hospitals do not have the medicines necessary even for emergency treatments. Patients are thus compelled to procure the medicines themselves.
The control probes initiated by the Ministry of Health often uncovered medical and pharmaceutical frauds. With “arrangements” between Pharmacy owners and hospital managers so that more patients are “stimulated” toward buying their medication exclusively from pharmacies. Which are the same pharmacies that sell even forbidden pills, falsified serums or medicines that, instead of curing, create dependency. Such an example is the xanax, which brings huge profits to pharmacies everywhere, because of the illusions it gives to those who are using it. It has an immediate positive effect, but does not solve the cause of the anxiety, of the obsessive panic for which it is intensely recommended.
The reverse effect is also frequent in using some antibiotics, which pharmacies sell sometimes with medical prescription, sometimes not. Because, unlike other states of the EU, Romania does not have a national policy for the reasonable use of medicines. The only exception here is tuberculosis. But only one positive exception does not justify a vast amount of negative situations. Which is amplified by the sales of medicines on the internet, at an increased cost that pretends to help patients buy products that are harder to procure in pharmacies. This explains the fact that antibiotics are used on a much larger scale in Romania than in other countries. Also this explains why uncontrolled antibiotics offer an entry gate to the organism for deadly bacteria. But, even in the case of antibiotics recommended by a doctor, if they are abusively used their therapeutic effect fades away in time and the abuse of antibiotics undermines the effect of other medicines.
Discrimination has become commonplace throughout the medical sector, helping pharmaceutical importers and providers to obtain maximum prices. With the contribution of political errors made in Romania over the last 16-18 years, when the local pharmaceutical industry was destroyed through fraudulent privatisations. Successively or simultaneously, there is a lack of numerous medicines used in the treatment of cancer, diabetes, kidney, cardiovascular or lung diseases. On many occasions, the pharmaceutical importers and providers act precisely in support of these crises of medicines, which help them raise to maximum the prices of their products and the profits they make out of them.
This – also moral – crisis present in the pharmaceutical sector sometimes also produces a beneficial effect of resurrection. For instance, the National group of independent pharmacies ‘Ethica’ aims at returning the patient and its real needs in the focus of attention, instead of concentrating on excessive profit. Thus, medical deontology and the quality of the pharmaceutical action gain precedence over the exclusively financial interest. But attaining these honourable goals depends on many factors, including the action of family physicians and policlinic personnel. Whose medical prescriptions are thus conceived to favour the profit of related pharmacies, connected with strong ties to these doctors. Such unfair practices are the source of fictive medical analyses that favour the false medical prescriptions whose costs are sustained from the state budget.
Precisely such practices amplify the discrimination in the medical sector. A hope for an improvement of the situation comes from the fact that the list of compensated and free medicines is currently on public debate, also by the organisations of patients. There are hints that it will be approved by the government in good conditions. Let’s hope this will really happen.

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