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According to the World Health Organization, Albanian citizens pay 60% of health expenses out of pocket.
The World Health Organization, WHO, has recently published updated data on health costs at the global level, where Albania ranks first in the region for the high level of expenses that citizens cover from their own pockets.
According to the latest data from 2021, an Albanian spends an average of 460 USD per year on health, which he covers from his own finances.
Egla Bardhi, executive director of the "Together for Life" organization, identified some of the main factors that influence the increase in the personal expenses of Albanian citizens in health.
According to Bardhi, one of the main reasons that citizens cover health costs out of their own pockets is because the health care law is not enforced.
"Our country is still unable to provide health services according to the protocols it has adopted," said Bardhi. "Those service packages that have already been approved are not available to patients," she added.
Similarly, Rigels Xhemollari from the Civic Center organization emphasizes that the state has failed to keep its promises regarding the health sector.
"The country that was the first to promise free healthcare in the region, came out first for private healthcare in Europe, where the citizen buys the agent, the serum, the medicine, possibly even the bribe," he said.
Xhemollari emphasized that during the pandemic, health costs increased exponentially.
"The presence of the state was negligible, except for resuscitation when the condition worsened to hospitalization," he explained. "Visits, echoes, medicines and any additional services that required treatment of COVID-19 were decided privately," added Xhemollari.
The shortage of drugs and medicines was not only noticed during the Sars-CoV-2 virus treatment needs, but is still felt today.
"A patient in Oncology who needs to carry out a therapy according to the protocol, it is impossible due to the lack of budget to provide the service, and as a result the patient is forced to buy very expensive drugs for chemotherapy," says Egla Bardhi , adding that only those patients who have economic opportunities can do this.
The leader of "Civic Attitude", Rigels Xhemollari, confirms the same phenomenon.
"A part of the service or products are bought by the citizens themselves, because some of the expensive chemotherapy drugs are missing in the QSUT, such as the case of the drug 'Velcade'", he emphasizes.
According to activists for patients' rights, another factor that affects the increase in health costs that citizens cover themselves is the phenomenon of "bribes" to doctors.
"Petty corruption is also present, increasing these costs, or forcing citizens to choose private hospitals," said Xhemollari.
According to Egla Bardhi, patients give these bribes with the desire and belief that they will receive a better service.
"Even the payments that occur to health personnel also increase the cost, with the belief that they can receive a better service, as these phenomena do not occur in European countries," said Bardhi.
Bardhi added that another factor that has influenced citizens to pay for health costs themselves is the reduced quality of drugs that are on the list of reimbursable medications.
According to her, since the legal changes of 2014, medications that are not from the EU market have been allowed to be introduced to the market, which have brought, according to Bardhi, "a decrease in the quality of medications."
"New medications are introduced into the health system, many times better than those on the list of reimbursable drugs, and in order to have a better treatment, patients buy these medications themselves," added the head of "Together for Life".
Loss of citizens' trust in the public health system
The increase in health expenses that citizens are forced to cover out of their own pockets translates into a decrease in their trust in the health system promised by the state.
"This translates into a decrease in trust in the propaganda of free health, in the public health system and in health insurance payments, which have increased with the increase of the minimum wage and do not provide us with minimum health protection," said Xhemollari.
According to the executive director of "Civic Attitude", the fact that some of the main health concessions are already under investigation, and not at the service of patients, weakens the trust even more.
"The main health concessions that would enable a better quality and dignified service to the citizen are under investigation by SPAK, and most likely they have not reached the expected goal", he emphasized.
According to Egla Bardhi, since citizens have a lower range of services they receive, as a result, their trust in these services has decreased.
"A good part of the patients also go to private clinics abroad, not only private ones in the country," said Bardhi.
She emphasized that Albania has one of the lowest budgets in the region for the health system, so this system is also deficient and unreliable.
"This phenomenon did not happen recently in our country, but it has been happening for 30 years," she concluded. / BIRN
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