Expert Analysis: What the KCUS Report Reveals, How Millions Were Saved

SARAJEVO, (Patria) - The report of the Clinical Center of the University of Sarajevo (KCUS) for 2016, presented at the Assembly of Sarajevo Canton on January 31, 2018, reveals several important and unacceptable things that the Health Committee of the Independent Bloc points out to patients and the interested public. The Patria Agency has insight into part of that report:

The report reveals irresponsible planning and budget manipulation with the redirection of taxpayer money to unplanned purposes. KCUS has an obligation to plan all its activities in advance and, based on a clearly defined plan, receive money from public funds for its financing.

KCUS is not a profit organization but a public institution and it cannot generate profit. KCUS is obliged to spend what it previously planned, after withdrawing money from public funds filled by taxpayers. For such a non-profit public institution, a small deficit is acceptable, but a large financial surplus is impermissible.

A particular aspect is that KCUS should not have shown profit at all, because in doing so it clearly demonstrated that the money it received after planning for clearly defined treatment activities was redirected to something else. And that something else is repaying existing debts and presenting the Management as a group of capable managers.

KCUS, as a federal public health institution, receives a lump sum of over 200 million KM, of which only from the Health Insurance Institute of Sarajevo Canton (ZZOKS) for the year 2016, according to the previously presented plan that KCUS itself prepared, it received a tranche of over 113 million KM.

With all that money, KCUS did not provide adequate service to patients or end users, but consciously, in order to save funds and redirect them to unplanned purposes, limited the realization of its own plan and reduced the provision of services to patients.

It was stated that 3.5 million US dollars from the Saudi loan were spent on relocating Plastic Surgery and Ophthalmology to a new building, which is untrue. Anyone who comes to KCUS knows that Ophthalmology and Plastic Surgery are in the same place and have not been moved to any new premises. Otherwise, obligations from the Saudi loan are exclusively related to ZZO KS, because the Institute repays it, and KCUS only spends and uses those funds.

Even a 20% reduction in the cost of consumables for laboratory diagnostics compared to the plan was recorded. This indicates why patients cannot adequately carry out diagnostic tests and why the crowds in the KCUS laboratory have decreased.

Also, 24% fewer clinical diagnostic services were provided than planned. This clearly shows why patients wait for MRI and CT scans, and why the mentioned devices are not repaired efficiently when they break down. The longer a device is broken, the fewer services are provided and the less planned money is spent, which is then redirected to showing profit and repaying debts.

The number of surgical procedures has been reduced, but revenues from compulsory health insurance have increased compared to the plan (ZZOKS gave almost 5 million KM more, the Federal Health Insurance and Reinsurance Institute gave 1.2 million KM more, donations were 4.5 million KM).

Nepotism is the main cause of the increase in KCUS revenues, not actual needs. This is an indicator that the KCUS Management is an incompetent and poor host because, with all the pumped money, it has an army of dissatisfied patients and employees.

KCUS used its inventories in 2016, reducing them by as much as 1.3 million KM during the year. All for profit in a non-profit organization.

If profit is realized in a public institution like KCUS (KCU shows a profit of about 11 million KM), it is a sign that the previous planning was poor, and the inflow of funds from public sources must be reduced the following year by the amount of the shown profit. However, under direct political influence, the inflow of money from ZZO KS to the Clinical Center is increasing, so in 2017 it received over 119 million, and in 2018 that amount is as much as 123 million KM.

The KCUS Management does not talk about KCUS's debt but talks about profit to create the impression that it is operating positively, which is direct manipulation intended to deceive the sick and euthanize the rebellion of healthcare workers.

The increase in funds from ZZOKS is desirable if it is adequately planned and serves to increase the volume of services for insured persons, but it is completely unjustified and politically motivated, with the intention of supporting the wife of the president of the ruling party, if that money is directed towards repaying debt so that the ruling party can realize its interests at the expense of untreated patients.

It is incredible that KCUS, with over 3,600 employees and 660 doctors of medicine (682 in 2015), the vast majority of whom are specialists, masters, doctors of science, and some subspecialists and academic staff (assistants, docents, professors), spent only 15,000 KM on education for 2016. Education costs at KCUS in 2016 fell 15 times compared to 2013. These are incredible data given the obligation of continuous medical education defined by law.

KCUS is the only institution in Sarajevo Canton that provides tertiary services and also covers a large area of the Federation. The persecution of experts and professors who perform the most complex and expensive services at the tertiary level has the character of irresponsible destruction of the health system. Such persecution reduces costs and increases effective control at the professional level, which is not done even in totalitarian societies. The report clearly shows that tertiary services are stagnating; we are sure that the new report for 2017 will show this fact in an even cruder form.

It is particularly tragic that health services, which KCUS planned but did not realize due to savings at the expense of patients, are being realized abroad by individuals close to the politics of the ruling party and the KCUS Management, using public funds. A direct example is the general director and her husband, who are treated abroad, not at KCUS.

The KCUS Management received more money from public funds but provided fewer services, reduced the number of specialized staff, reduced education costs, reduced the volume of work including the tertiary level, and reduced the number of patients who are intentionally driven out of KCUS or flee themselves aware of the circumstances.

ZZOKS is completely at the service of the KCUS director. The Institute increases funds for KCUS year after year, while decreasing them for other health institutions. The Institute plans its activities according to the wishes of its commanders (it is interesting that for this year ZZOKS planned 6,000 hyperbaric chamber services at a unit price of 100 KM, which is 600,000 KM, solely because it is in the interest of individuals from the KCUS Management, even though the indications for the hyperbaric chamber are extremely narrow and it is absolutely unnecessary to have that number of such services in Sarajevo Canton).

In summary, this is criminal manipulation and a direct threat to patients, and we openly call on the Federal Government to dismiss the incompetent and corrupt KCUS Management Board led by Dr. Jasmin Kapetanović and thus save the health system of Sarajevo Canton from the political terror of the wife of the president of the ruling party - the analysis states.