Thousands of Romanians gathered in the last few days at the counters of Health Insurance Houses and spent hours standing in rows in a final attempt to get the health cards they still failed to receive by post mail, doctors refused to provide treatment to patients who did not have this document at them and Minister Nicolae Banicioiu was called back from his holiday and questioned, in order to provide explanations.
The fact that, initially, it was announced that, starting on May 1, patients will only receive medical care based on the health card, combined with the last minute announcement made by Vasile Ciurchea,the President of the National Health Insurance House (CNAS) that the almost one million Romanians who were unable to get this tool will also receive treatment and with the refusal by family doctors, confused of so many changes, to provide healthcare to patients who had no health card and the blocking of the IT system had led to genuine chaos.
Tuesday saw the peak of the card hysteria because, in the morning and at noon, no compensated receipts could be issued and no referrals to specialist doctors could be made because the IT system that supported health cards was blocked. In the meantime, at health insurance houses, rows were endless, as people had come to redeem the cards they did not receive at home.
About the blocking of the system, CNAS announced that suppliers of services were guilty for the inconvenience. Vasile Ciurchea suggested that such issues are unavoidable if people are unwilling to cooperate: “Do you think that I want the system to be blocked? If we do not work together, it will not work”. After noon, he declared that the system was working. “You were supposed to learn how the card worked since December. If we keep playing with cards in readers, they obviously get blocked”, he declared.
Ciurchea also announced family doctors that they should introduce the card in the reader and, if it fails to answer, they should continue the exam without any issue. Moreover, he stated: “If you introduce the card any time you are using your stethoscope, it will obviously get blocked.” About this situation and possible sanctions, he mentioned that these will exist, but no solution will appear “if I issue a fine today or I cease the contract with a supplier. Sanctions may be issued in a few days, as well.” He accused doctors that they wanted to delay the introduction of cards and that they are unjustified in sending patients to Health Insurance Houses. “How much more are we supposed to delay it? I have repeated each time what the steps are and how the card is supposed to be used.”
“Complaints keep coming from insurance beneficiaries about the fact that a few suppliers, without any justification, refuse to grant them healthcare in the absence of health cards. The control teams of CNAS and health insurance houses will perform visits at offices to solve each case. We keep inviting patients to signal us the eventual issues, so that we can solve them and make sure they have unlimited access to medical services”, Vasile Ciurchea further declared.
CNAS representatives once again insisted that people who did not get their health card will keep receiving medical care based on their quality of insurance owners and recommended that persons who did not acquire their health cards should access the IT platform on the site and check whether the document is at CASMB, mentioning that “there are requests concerning documents that are not at us.”
At national level, on Monday, the first working day after the short holiday of May 1, 224,470 medical and pharmacy services were granted to patients. 136,556 services were granted without health card and no more than 87,914 services were validated with the health card, the National Health Insurance House (CNAS) mentioned on Tuesday, according to Agerpres. According to CNAS, of all these services, at national level, 70,892 receipts were issued without health cards and 24,693 receipts were validated by card.
In Bucharest, over half of the medical and pharmacy services were granted in the health card system. Therefore, 9,130 services were validated by card, and 4,084 of them were provided by family doctors. Moreover, 9,062 services were provided without health cards, 5,356 of which were provided by family doctors.
According to CNAS, services granted without being validated by cards will be paid to suppliers, but monitored distinctly at the level of CNAS, in order to facilitate the submission of cards to insured parties, who were unable yet to get their cards.
So far, Health Minister Nicolae Banicioiu only managed to ask the representatives of the Public Health Department and CNAS to perform controld at offices of healthcare suppliers and check whether they have purchased health card readers, whether they have properly trained staff to use the health cards and whether they have the required software in order to use the system.
Some of the issues identified on Monday were also caused by the fact that some doctors failed to understand how the health card worked. By example, the health card needed to be introduced in the reader and kept there until the insurance beneficiary introduced the PIN he had selected and received the validation of the PIN from behalf of the system. All of the other operations, respectively the medical examination and issuing the receipt, could be done after the card was removed from the reader.
Because of this reason, some family doctors needed as much as four hours to examine three patients, as they had pointed out.
Most physicians complained that the system got blocked frequently and the card validation is difficult. According to the National Society of Family Healthcare, doctors all over the country reported two types of error, both making card activation impossible, respective unavailable UM and unavailable Token.
If family doctors experienced situations, according to their declarations, when n more than three patients could be examined in four hours, hospitals reported a different state of things. By example, at the “Sfanta Maria” Hospital in Bucharest, the admission file to the hospital was filled out in an average time of 15 minutes, based on the health insurance card.
On Tuesday, the Health Committee of the Chamber of Deputies unanimously decided, after the proposal of PNL members, to call Health Minister Banicioiu and CNAS President Vasile Ciurchea to a hearing next Tuesday, at 12.00.
Moreover, the Parliament group of Liberals in the Chamber of Deputies invited Nicolae Banicioiu to attend a discussion on the topic of health cards, scheduled on Monday, starting at 3.00.
Family doctors say that the IT system that supported health cards got completely blocked. On Tuesday morning and around noon, no compensated prescriptions could be issued, nor referrals to specialist doctors. In the meantime, at health insurance houses, there were endless rows as people came finally to acquire their health cards.
On Thursday, the representatives of the National Health Insurance House admitted that there were operating issues in the health card system. The most frequently encountered issues are those experienced by suppliers of medical services who are using different software than the one offered for free by CNAS.
Nonetheless, PM Victor Ponta announced on Friday that “everything went on fine” in the first day the health card was used, and congratulated Minister Banicioiu, as well as “all of those who had worked in order to make the system functional.”
PNL demanded the dismissal of the Minister
PNL Co-President Alina Gorghiu demanded on Tuesday that Health Minister Nicolae Banicioiu be dismissed for the operating issues of health cards and the assumption of public responsibility by PM Ponta for the severe problems in the health system.
“While hundreds of Romanians are waiting in line to get in possesion of their health cards, doctors are unable to issue prescriptions, patients are refused medicine compensations and, even worse, hospitalization in certain cases, the Health Minister sends instructions from thousands of kilometres away, straight from the Prime Minister’s Arab tour. Minister Banicioiu chose to leave as a member of the Prime Minister’s official delegation precisely during the start of the health card implementation. PSD is indeed a sick party, without any chances of recovery, ever, and the Health Minister is has become a danger for public health”, Alina Gorghiu declared for Mediafax.
Gorghiu mentioned that, “just as Nicolae Banicioiu and Victor Ponta had advanced in their positions together, as leaders of the PSD youth wing, and they share the foreign visits made by the Government, they should leave their positions similarly, together.”
“I request the immediate resignation or dismissal of Minister Banicioiu, until the landing of the official plane and the assumption by the Prime Minister of the severe issues in the health system”, Gorghiu declared.
The PNL Co-President mentioned that she was not referring merely to the “latest crisis, the one of health cards, that overturned the entire system, but also to the decrease in the rate of vaccination, from 95 per cent in 2013 to 80 per cent in 2015, a figure considered as dangerous by experts, to the almost inhuman conditions encountered in Romanian hospitals and, overall, to the humiliating way the state treats both doctors and patients.”
PM Victor Ponta: We need health card, combating waste, fraud in healthcare system
Prime Minister Victor Ponta said on Wednesday that the introduction of the electronic health card is the most important change in the relevant field, with combating waste and fraud being among its effects.
“We need health card and combating waste and fraud in healthcare system. Mr. Minister [Nicolae Banicioiu], I want you to fix the problems at the House [Health Insurance House CNAS]. If the health card is applied, some doctors will no longer be able to say they have 2,000 patients per day and consume medicines worth millions of euros. I am convinced that the system has to be improved, but, at the same time, it is the most important change we are making in healthcare sector. You will save hundreds of millions of euros and all the money, without any exception, remains at the Health Ministry and you already have, as of this year, an important resource,” said the prime minister according to Agerpres.