HDZ-SDA Political Kitchen: Writing off hospital debts on the backs of citizens

The healthcare sector in the Federation of Bosnia and Herzegovina is indebted by an incredible 370 million marks. Of that amount, 107 million marks is owed by the University Clinical Hospital Mostar, according to director Ante Kvesić, while the debt of the University Clinical Center Sarajevo is 100 million marks, according to director Sebija Izetbegović.

The two clinical centers, one in the western part of Mostar and the other in Sarajevo, owe a total of 207 million marks for various reasons!

The accumulated debts have not been addressed by anyone, and this has significantly impacted, and continues to impact, the entire healthcare system. Patients ultimately pay the highest price for all of this, as a considerable amount is regularly deducted from their salaries for health insurance.

For example, in Sarajevo Canton alone, the Health Insurance Fund has a budget of 350 million marks, yet the services from health centers to the University Clinical Center Sarajevo are not up to par. Patients wait for months for some examinations, and they even buy bandages and gauze themselves when going for hospital treatment.

In recent days, the issue of writing off the debts of healthcare institutions in the Federation has been актуализирована. This initiative was launched by the Assembly of the Herzegovina-Neretva Canton (Livno Canton), where HDZ BiH representatives form the majority, and sent to the Federal Government in May last year.

A year later, the leadership of the House of Peoples of the FBiH Parliament, headed by Speaker Lidija Bradara, began visiting, first the Mostar, and then the Sarajevo clinics. It is undeniable that healthcare in the Federation is in chaos and on the verge of collapse. It is undeniable that there are huge debts. Furthermore, healthcare reform must be urgently implemented, but clearly, based on the moves made in recent months, there is no sign of reform.

Either those who are supposed to do it are completely incompetent and don't know where to start, or the ultimate goal is solely to write off the debts of the hospitals in Mostar and Sarajevo under the guise of healthcare reform.

The Federal Parliament is expected to hold a thematic session in the near future to consider the initiative to write off debts.

How do those who devised this plan intend to implement it, given that the situation with budgets at all levels of government, especially in the FBiH, is catastrophic?

Logically, the Tax Administration, Financial Police, and other competent institutions should first thoroughly scrutinize all financial reports of healthcare institutions in FBiH, including the hospitals in Mostar and Sarajevo, and determine the actual state of debts and the reasons for them.

After the actual situation is determined, the structure of the debt will be examined. For instance, how much does the University Clinical Center Sarajevo owe for taxes and contributions, how much to suppliers, third parties, etc.

In this case, the FBiH Government can write off debts only when it comes to taxes and contributions, which means it will have to dip into an already depleted budget and make payments to the Pension and Disability Insurance Fund (PIO/MIO).

The government cannot write off debts to suppliers or third parties, as seems to be planned in political centers of power. This would mean that all of them would sue the Government and win their cases in court if that happened.

If the Government were to decide, due to what appears to be intense pressure from HDZ BiH, which SDA gladly joined, to write off debts to suppliers and third parties as well, then in that case, the Government, taking on the obligations, would have to borrow further by taking out loans to pay off the debts of the healthcare institutions.

Whatever is planned cannot be done without first establishing a new legal framework that will define this burning issue.

Regardless of how it is done, the Government or the FBiH Parliament cannot do anything solely based on a decision to write off debts. However, what is concerning is that, for reasons unknown, everything is being done on the backs of the citizens once again.

They have already paid contributions for health insurance once, and in return, they receive almost no minimum medical services or assistance, and more and more people with money are turning to private clinics.

Then, a second time, if the Government writes off the debts of healthcare institutions for unpaid contributions and taxes, which it will naturally do from the budget funded by citizens' pockets.

And a third time, if a politically motivated decision is made to write off all debts (regardless of their structure) and the Government takes on new debt through loans. Turn it around, flip it over, citizens would pay for healthcare services three times, and no one would ask them about anything, just as they haven't been asked so far.

Moreover, they will never find out who is responsible for the accumulated debts, who illegally took their money, how it was wasted on salaries, how tenders were rigged... nor will anyone, it seems, ever be held criminally responsible from 1996 to date for the waste of money in the healthcare sector, for which services are paid dearly.

The names of those who, over the past two decades, during which the largest debts were incurred, and who sat in the director's chairs from the University Clinical Center Sarajevo, to the Mostar hospital, to health insurance funds, are known. If desired, those responsible can be easily identified and prosecuted for illegalities.

That is not the goal. The goal is to write off the debts of the hospital in the western part of Mostar and the University Clinical Center Sarajevo, so that both Kvesić and director Izetbegović can start from scratch, and then claim to be excellent managers.