“The future Minister of Health, Bešič Loredan, may have sincere good intentions, but it will be very difficult for him to reconcile them with the direction written in the coalition agreement, which is diametrically opposed to what he says and what he did as a doctor,” said Doctor Tina Bregant.
The most likely future Minister of Health and Deputy Prime Minister will be Danijel Bešič Loredan. On Tuesday, he was a guest on the show Odmevi (Echoes) on the national television station RTV Slovenia, with the host of the show Igor E. Bergant. As it was announced, the future coalition will focus on solving the coronavirus problem, the lack of general practitioners, and will also try to shorten the waiting times, as the current situation is unbearable. It was also stated on the show that patients have to wait for six years to see a specialist and two weeks to see their personal physician. Another unacceptable thing that is happening is the shifting of dates of surgeries, even for two years. What is also important is to raise the salaries of therapists and physiotherapists, radiologists, as well as laboratory workers and pharmacists, who were not included in the first set of negotiations with the current government.
Long-term care will be placed under the auspices of just one ministry – the Ministry of Health and the systemic solutions also include the abolition of supplementary health insurance and the complete separation of public and private healthcare. With this, the future government is also planning to abolish the afternoon work in private clinics of doctors who also work in public institutions, in a two-year period, which was already met with sharp reactions from young doctors. Ensuring better working conditions is key to keeping doctors in public institutions. They are also planning to establish the Office for Patients’ Rights, the Fund for Exceptional Patients, the regulation of the field of mental health care, and start the production of medical cannabis under the auspices of the state.
Regarding the measures to contain the novel coronavirus that we might see in autumn, Bešič Loredan said that if this autumn’s situation were similar to the ones we have seen in the last two years, the public healthcare as we know it would end. That is why they are planning to prepare an appropriate strategy on which they will work throughout the summer. The goal is to include the treatment of covid-19 in the existing healthcare system and treat all patients equally. At the beginning of September, a strategy will be presented, from which there will be no deviations, and which will be led by the National Institute of Public Health – and, above all, it will not change from one week to the next. There will certainly be no compulsory vaccination, not even for the elderly, but a more detailed strategy for this age group will be presented later. They intend to take a positive approach to promotion, especially for the groups of people who are most at-risk.
The abolition of supplementary health insurance is also planned
“General practitioners are already making suggestions that have never been fully taken into account, and now we will try to take them into account as much as possible, with an intervention law, with measures. After all, we are spending 500 million euros in 18 months for this purpose. Why? So that we can push the healthcare system to the upper limit and see how much it can do so that all services will be paid after realisation, so that general practitioners will have administrative assistance and will be able to actually deal with treatment…” Regarding the long waiting times, Bešič Lordan highlighted the partial lack of money and irrational management.
He was not yet able to disclose any details regarding the transformation of health insurance but said that in the next year and a half or two, they will be looking for a system that could best be placed in the Slovenian healthcare system. It is also crucial that they manage to raise 600 million euros and they consequently abolish the supplementary health insurance. At the same time, they also intend to ensure the same working conditions in public institutions and in private ones. A doctor could who works in the morning or in the afternoon should be paid the same. As a result, there will no longer be a need for a doctor to work outside a public institution, in a private one. The future Minister of Health also announced the merging of the social and health work of long-term care “under one roof.”
Do they think we are fools? There is a huge discrepancy between the coalition agreement and the wishes of Bešič Loredan
SDS MP Jelka Godec commented on what Bešič Loredan said on the TV show in question, writing: “Mr Danijel Bešič Loredan is, for now, only a candidate for the position of Minister of Health, he is not yet the Minister, even though he is speaking to the media as if he is a Minister already. His views and proposals in the field of healthcare will be assessed after the hearing at the competent working body in the National Assembly is complete.” Tina Bregant, a specialist in paediatrics and physical rehabilitation medicine and a former state secretary at the Ministry of Health, also shared her opinion on the matter, saying: “I do not know Mr Bešič personally. However, I know that he is a doctor with experience gained both at home and abroad and that years ago, he even collected signatures for the resignation of the former Minister of Health, Milojka Kolar Celarc.”
“At the time, she proposed some laws that were quite harmful to doctors, including the Medical Practice Act.” She also proposed the abolition of supplementary health insurance, which was not successful. And, in fact, there is an interesting, even worrying discrepancy between what the future Minister is saying and what he also did as a doctor and what has been written into the coalition agreement, by consensus of the parties of the future government. “It is this discrepancy that is unusual and, in fact, even worrying. Because this means the following: perhaps, the coalition agreement is a “Potemkin village” and is merely likeable but completely irrelevant in terms of content, so the content will be worked out elsewhere. In the background, where there is the real, deep, non-transparent state that holds power. One could even say that they believe we are fools and that this is all just a performance, put on for the public.”
Public healthcare will collapse, and young specialists will become precarious workers in private clinics
“And the other option is that Mr Bešič did not even take part in the writing of the coalition agreement at all, or that he did not even read it in its final form.” Bregant even assumes that Bešič Loredan has sincere good intentions, but it will be very difficult for him to reconcile them with the direction written in the coalition agreement, which is diametrically opposed to what he says and what he did as a doctor. She also responded to the announcement of the abolition of supplementary health insurance. Bregant believes that half a billion euros is not a small amount of money and that a serious question arises as to where we will get this much money if we abolish supplementary health insurance. Perhaps through additional taxation of work? And if some are convinced that we do not need supplementary health insurance, they are mistaken. Compulsory insurance shifted a share of services to supplementary insurance (around the year 2006). What started to happen then is that people without supplementary health insurance, who ended up in the hospital, were forced to pay an additional, considerable amount for the services they got.
She also touched on the areas of work regulation in the public and private healthcare sectors. The measures set out in the coalition agreement will lead to an outpour of the best, young specialists (not young doctors, who are still learning, because they cannot work anywhere else but in public healthcare), who will leave because of a higher salary (a lure that will take them out of public healthcare) to private clinics. Public health will collapse, and supplementary insurance will be abolished. And the doctors will work for private individuals who own clinics with concessions, but they will probably only be employed as precarious workers, which means that private individuals will be making a profit at their expense.
Covid has become an endemic: let the medical profession deal with it
And what is crucial in this situation is not being problematised. And as long as this is not problematised, it will lead to the disintegration of public health. Regarding “causing a panic” and tackling the epidemic differently in the autumn than how the Janez Janša government did it, Bregant said that covid-19 had already become a disease at the level of influenza or a cold (due to the omicron strain itself, vaccination and the number of already recovered people), with which the profession and the National Institute of Public Health should be dealing anyway. We came from a pandemic to an endemic form of a disease, and above all, we have more than two years of experience, which changes the matter greatly.
“Let’s resist the path that leads us in the direction of the Soviet Union!”
Infectious disease specialist Federico Potočnik also presented his view of the situation: “We will judge the new government by its actions. So far, the only tangible product is the coalition agreement, which looks a lot like a rewritten programme of the Left party (Levica).” As a citizen and a doctor, Potočnik is disappointed that the vision of this extreme party is detrimental to Slovenian healthcare and society as a whole. He believes that the ministerial candidate Dr Bešič Loredan does bring some hope, although he feats his work will be regulated by the coalition partners. The announced measures all have one thing in common, namely – they reduce personal freedom and choice.
Banning afternoon work means less freedom in arranging employment. Raising taxes in practice means that the government will take more money from citizens and spend it by itself. Abolishing supplementary health insurance would erase the little choice that the system still offers. The centralisation of new purchases and other services, however, is nothing more than shifting the decision-making to the centre, while the rest of us become dependent on their instructions, which in no way strengthens personal responsibility and active citizenship. “Unfortunately, we are witnessing the attempt of a complete takeover of healthcare, which the far left wants to carry out, even though it barely managed to get into the National Assembly at all. I think it is the duty of all honest people to resist the path that leads us in the direction of the Soviet Union,” Potočnik also warned.
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