Guvernul a aprobat sistemul de coplata in sanatate
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Este vorba despre un proiect de modificare a Legii 95/2006, document ce se afla pe site-ul ministerului, in dezbatere publica si in consultari cu partenerii sociali de mai bine de 7 luni si care a fost aprobat in 24 noiembrie in cadrul sedintei de Guvern.
Proiectul intra in dezbatere parlamentara in 2011. Ministerul previzionand ca, in cazul aprobarii sale de catre Parlamentul Romaniei, sa se aplice incepand cu 1 iulie 2011.
Potrivit unui comunicat publicat pe pagina de Internet a ministerului, sistemul va fi bazat pe contributia individuala plafonata la o suma maxima de 600 lei, contorizata prin intermediul tichetelor moderatoare de sanatate, ce vor functiona ca instrumente de plata continand elementele de identificare ale platitorului Bonus Fara Depunere
Privit de autori ca o modalitate de constientizare a populatiei referitoare la costurile pentru sanatate si la "responsabilizarea fata de consumurile proprii de servicii", mecanismul de coplata va genera si venituri suplimentare pentru furnizorii din sistem, unde vor ramane aceste sume (cabinet medical individual, unitate sanitara, spital), calculele specialistilor din minister avansand o cifra de 378 milioane de lei/an.
Coplata va reprezenta contributia personala a pacientului la plata serviciilor medicale, fiind realizata prin intermediul tichetului moderator de sanatate, care se va elibera pacientului si va reprezenta documentul doveditor al realizarii actului medical si a platii acestuia.
Mecanismul de coplata se va aplica doar "la medicul de familie, la medicul specialist si in spitale. Nu se va aplica la serviciile de urgenta", a mai precizat ministrul Sanatatii.
Exemplele postate pe site-ul ministerului avanseaza urmatoarele sume platite prin tichetul moderator de sanatate, pentru diferite categorii de servicii medicale: 5 lei - vizita la medicul de familie, 10 lei - consultatia la medicul specialist din ambulatoriu, 10 lei - coplata pentru spitalizare, 50 lei/episod de internare - spitalizarea continua.
Proiectul de modificare a Legii 95/2006 mai contine prevederi referitoare la scutirea de la obligativitatea coplatii a urmatoarelor categorii de pacienti:
- pensionari cu pensia mai mica de 700 lei/luna;
- copii sub 18 ani si tinerii cu varsta intre 18 si 26 de ani fara venituri;
- bolnavii inclusi in programele nationale de sanatate, daca nu realizeaza venituri din munca;
Cu alte cuvinte, mai precizeaza comunicatul, doar 62% din populatia Romaniei va fi obligatoriu inclusa in circuitului coplatii, in vreme ce peste 8 milioane de persoane vor fi scutite de obligativitatea coplatii.
In plus, in afara de categorii de persoane ce nu vor fi incluse in mecanismul de coplata, vor exista si categorii de servicii ce nu se vor plati, cu urmatoarele exemple:
- unele servicii acordate bolnavilor avand afectiuni incluse in Programele de sanatate, pentru afectiunea de baza: "sedintele de chimioterapie, de radioterapie si de hemodializa si dializa peritoneala etc.";
- urgente chirurgicale (accidente, plagi prin taiere, impuscare, apendicita acuta, colecistita acuta, fracturi etc.);
- urgente medicale (infarct miocardic, colica renala, come etc.), daca pacientul se interneaza in spital prin UPU, CPU sau Camera de Garda;
- categorii de servicii acordate bolnavilor cu afectiuni endemo-epidemice (boli infectioase acute pana la stabilizarea bolnavului, boli transmisibile, pana la negativare);
- nasterea.
Comunicatul ministerului mai precizeaza faptul ca, odata atins plafonul maxim de 600 lei/an, pacientul nu va mai achita coplata si ca acest sistem va contribui la "stabilirea traseului corect al pacientului in sistemul de sanatate”, fiind inspirat din experienta altor tari cu dezvoltare asemanatoare (Croatia, Estonia) unde un astfel de sistem este deja operational, precum si urmand exemplul tarilor din Europa de Vest, tari cu o indelungata experienta in gestionarea contributiilor suplimentare in sistemul public de sanatate.
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