Civil society organizations that gather patient users of the Solidarity Fund of the Federation of Bosnia and Herzegovina (FBiH) have again warned about the perennial problem of ignoring the legal obligations of the Government of the FBiH regarding the financing of the Solidarity Fund of the FBiH.
“The previous practice of the FBIH Government of not complying with the obligations of financing the FBiH Solidarity Fund prescribed by law, calling into question the right to health care for the citizens of the FBiH, must be changed,” is one of the key messages from the round table organized by the Centers for Civil Initiatives.
“Patients with pulmonary hypertension are denied basic human rights: the right to life, the right to medicine, and we believe that such a situation will be significantly improved by the FBiH Solidarity Fund in cooperation with the competent ministries, above all, in equalizing the right to treatment of all patients when it comes to our expensive therapy, as well as for the purchase of expensive devices such as oxygen concentrators, portable oxygen concentrators, and CRAP devices, and then for all interventions outside the country, which even in our case include heart, lung or both heart and lung transplants,” said Samir Hodzic, representative of the Association of Citizens with Pulmonary Hypertension in BiH.
Every year, much less than the prescribed amount of money is allocated to the Solidarity Fund, from which the seriously ill are treated. The Law on Health Insurance obliges that the Solidarity Fund be allocated annually from the budget in the amount of income generated from contributions for mandatory health insurance.
The FBiH Solidarity Fund was established in 2002 within the FBiH Institute of Health Insurance and Reinsurance in order to create equal conditions for the implementation of mandatory health insurance in all cantons in the FBiH and to provide the opportunity for patients from financially weaker cantonal institutes to use the most complex and expensive forms of health care:
“Although the FBiH Health Insurance Law clearly prescribes the obligation to finance the FBiH Solidarity Fund, the Government of FBiH, since the establishment of the Fund, has never complied with this obligation in the amount stipulated by law, which directly prevented a certain number of patients from being provided with appropriate health care. More precisely, the Government of FBiH currently allocates less than 20% of the legally stipulated amount for the FBiH Solidarity Fund,” Centers for Civil Initiatives warn.
The chronic lack of financial resources has resulted in the establishment of a waiting list for certain types of services (primarily for cytostatic treatment services and multiple sclerosis treatment as well as for programs in the field of cardiology and cardiac surgery), which complicates the work of the Fund, and makes it impossible to provide services to patients at the time of the need for them. Because of all this, civil society organizations request that the Government of FBiH respect the obligation prescribed by law to finance the FBiH Solidarity Fund and increase allocations from the FBiH Budget for the work of the Fund, thereby showing responsibility and sensitivity for the health of FBiH citizens.
Since there has been no significant increase in income in recent years, and the Institute cannot solve the waiting list, problems with financing and purchasing drugs under special programs of the Ministry of Health and the Board of Directors have also accumulated. In this way, legal regulations are constantly being violated, because it is possible that about 2 percent of patients use almost 18 percent of the total funds spent on medicines.
“At the audit request, no documentation was presented that refers to the criteria and method of including patients in these special programs, and how the Institute monitors and supervises the implementation of these special programs,” stated the auditors in earlier reports.
The funds from the budget to the account of the Fund did not increase for eight years – from 2010 to 2018. They amounted to 26 million BAM per year, only to be increased to 28.5 million BAM in 2019, which is still not enough for all seriously ill patients, Zurnal writes.
E.Dz.