Due to long waiting lists in public health institutions, BiH citizens increasingly opt for private clinics

(Patria) - The ubiquitous approach, both in Bosnia and Herzegovina and worldwide, is that health is a commodity sold on the market. Whoever has more money will buy better. For better healthcare services, citizens seek private clinics – those who can afford it get it, those who cannot, wait, and if they live to see it.

How much do citizens spend on private healthcare services, despite mandatory health insurance, which does not guarantee timely, modern healthcare services?

"I decided to have surgery privately and finished everything privately very quickly, it took about 18 days for everything to go through, from findings, pathology reports, to surgery, and another 15 days for the final pathology report. If I had gone through our regular health insurance, it would have taken about 3-4 months, so in situations involving cancer, that's a lot," says Amela Lučkin.

Various tests and surgery required about 20,000 marks for a year. For cancer patients, this means pathology reports ranging from 800 marks to four thousand, biopsies from 280 marks to two thousand, and surgery for six thousand marks. With the help of relatives, friends, and her employer, Amela succeeded in her fight for life. In a system lacking staff, equipment, and modern approaches, citizens manage as best they can, or are forced to wait.

"Private healthcare institutions have much shorter waiting lists, almost none. They have better and higher quality equipment than public health institutions. Unfortunately, in private healthcare institutions, there is a tendency that is characteristic, where various tests and examinations are invented and accumulated to inflate the price of such healthcare services," emphasizes prim. dr. Dragan Stevanović.

Contributions for mandatory health insurance in the past year accounted for 91.97 percent of all revenues in health insurance funds, meaning citizens finance the healthcare sector with their own funds in the form of payroll contributions. The average monthly income for healthcare per worker in RS is around 250 marks.

"In 2023, in FBiH, total contributions for mandatory health insurance of employees in FBiH amounted to about two billion marks. The largest burden in providing funds for healthcare is borne by employees working for employers. The Institute contracts financing of health services and medicines financed by the Solidarity Fund of FBiH with healthcare institutions through public procurement," state the Health Insurance and Reinsurance Institute of the Federation of Bosnia and Herzegovina.

The situation is somewhat more favorable in the Republic of Srpska, given that the Health Insurance Fund has been contracting healthcare services with private healthcare institutions for more than 15 years.

"If diagnostic services, such as magnetic resonance imaging and CT scans, were not contracted with private institutions, the waiting times for these services would be significantly longer than they are now. We note that in private institutions that have a contract with the Fund, insured persons have the same rights as in public institutions, meaning they only pay a co-payment unless they are exempt from this obligation," state the Health Insurance Fund of RS.

It is clear that things can be done when there is a will, as evidenced by the abolished co-payments for all health services in KS, and the abolished waiting lists for cancer patients in this canton.

"Large sums of money are allocated for healthcare, for contributions, but it's not even a tenth of what... For example, how much my treatment costs. My health insurance, since I've been working, doesn't cover even a tenth, so we're in some kind of dead end there," says Amela Lučkin.

And perhaps the waiting times for examinations would be shorter, the opportunities for patients greater and easier, the staff friendlier, if doctors in public institutions did not work in increasingly worse conditions. Considering the lack of staff, different incomes across cantons, outdated equipment in most health institutions, and the failure to follow modern trends in equipment procurement, it is not surprising that both doctors and patients are increasingly turning to the private sector.

(BHRT)