Addressing the Challenges of Gesy’s Overutilization
The national health scheme Gesy has been a subject of pride for many in Cyprus, often heralded as a significant achievement for the nation. However, the latest evaluation report sheds light on critical issues that threaten its sustainability. The scheme’s introduction was met with a reluctance to critique, save for the notorious waiting lists. Yet, the recent findings suggest that without prompt and decisive action, Gesy’s future could be at risk.
One of the primary concerns highlighted in the report is the rampant overutilization of healthcare services. Since there is no direct cost to patients, there has been a surge in demand for treatments and medical tests, even for minor ailments. This “patient-driven” approach disregards financial implications and fosters an entitlement culture where expensive and unnecessary procedures are often demanded.
The proliferation of clinical labs and diagnostic imaging facilities across neighborhoods is indicative of this trend. The report questions the necessity of such an expansion, especially when the healthcare needs of Cyprus were adequately met with fewer facilities just five years ago. The difference lies in the payment structure; previously, when patients bore the costs, medical tests were sought only when necessary.
Moreover, the scheme has inadvertently led to a boom in the healthcare industry, with new businesses emerging to cater to the inflated demand. This surge is not reflective of an increase in illnesses but rather the consequence of free access to services.
Private hospitals’ practices within Gesy have also been scrutinized. They often transfer patients with pathological conditions to state hospitals due to lower reimbursement rates, while possibly conducting unnecessary surgeries for financial gain. The Health Insurance Organisation (HIO) has struggled to implement effective controls over these abuses, and personal doctors, initially tasked as gatekeepers, have not curbed the excessive referrals and testing.
The lack of a proper healthcare culture and patient education is cited as contributing factors to this overutilization. The report suggests that creating such a culture could take years, time which Gesy may not have if funds continue to be depleted at the current rate.
To combat these issues, the report proposes that the government introduce higher charges for medical actions and referrals. While this may be met with resistance, it is presented as a necessary measure to preserve Gesy’s integrity, prevent increased monthly contributions, and reduce waiting times. Ultimately, introducing a cost element could be pivotal in reshaping the prevailing culture of entitlement and ensuring the longevity of what has been deemed one of Cyprus’s greatest achievements in healthcare.
