Nine collaborative provisions have been introduced by Economic Policy and Research Center (EPRC) in a new publication titled Strategic Vision of Health-Care Sector Development. The document was developed by a working group, members of which did this job on a voluntary basis.
Nine main provisions are: (1) Health is an asset and an integral part of human capital. An individual has the right to be protected against harmful effects of the physical environment on his/her health; (2) Individuals are responsible for their own health. Society has an obligation to create a safe environment for health; (3) the role of medicine (medical interventions) in health is limited. The healthy lifestyle and environment play a decisive role in good health; (4) in a broader sense, the ultimate goal of the entire health care is prevention: prevention of the onset of a disease, in case of disease prevention of its permanent disability, deterioration of quality of life, and above all, early death. Success in taking care of health (and consequently, in efforts of society or individual) is measured by a result: healthy longevity (i.e. “health adjusted life-years”); (5) besides the compulsory expenses to create a safe environment, society fully covers the primary prevention, as well as the medical services for the secondary prevention (a guaranteed universal physical and financial access to medical services on the level II prevention). The expenditure on prevention as share of the total current expenditure on health has at least doubled, and increases every year; (6) A financial burden of managing and treating a disease that results from the individual’s disregard (irresponsible behavior) of secondary preventive measures is fully borne by the individual (society may relieve the burden within pre-defined parameters); (7) Each citizen responsible for his/her own health enjoys equal protection against the financial risks of getting individual medical service envisaged by this responsibility; (8) The consumption of individual health services is primarily financed from prepaid (pooled) funds, and (9) The purchase of medical service with prepaid funds serves the purpose of improving nation’s health in the long run.
This last provision sets on specific principles, which are: (a) Rules of the game are defined, whereby the balance between the parties to a triangle (payer/buyer, supplier and patient/customer) is maintained and the role of the state as a guarantor of this balance is determined; (b) Medical service tariffs are not set unilaterally; (c) The establishment of minimal quality standards of medical service is a prerogative of professional self-regulation, and (d) Technological innovations are introduced to the market under a trilateral agreement through „technology assessment mechanism.”
In the foreword to the publication, members of the working group including health specialists, decision-makers, economists, etc. clearly identify what is the main goal of the publication. “Our goal is twofold – they state - First, we aim to stimulate a public discussion on the key provisions which, unless accepted by the stakeholders, will remain empty words and unattainable aspirations, even if they are adopted as legislative norms or official policy. Second, by presenting our version of these principles, we aim to set an example of how people embracing different views may achieve agreement on issues of public importance”.
According to the working group, declaration will be followed by a series of essays as the provisions set out in this document may spark off separate debates. As said, the essays will outline a discussion forum for these debates and try to present diverse opinions, and to explain why our team chose a particular provision over its alternatives.
“We realize that the current political context and the forthcoming parliamentary elections might not leave much room for discussing a long-term vision of issues that are important for citizens. We believe, however, that now is the right time to start the discussion because regardless of who will make policies in the country’s development in the next few years, the country needs a strategic “road map” to ensure that the health sector develops without abrupt shifts” – members of the working group declared in the foreword of the EPRC’s new publication - Strategic Vision of Health-Care Sector Development.
