Our View: Gesy’s billions demand real accountability

The budget of the HIO (Health Insurance Organisation), which administers Gesy, will exceed €2 billion this year. It was unanimously approved by the House on Thursday, although it sparked some minor critical comments about the way it was expanding.

The HIO budget had more than doubled in the space of about 10 years, said Edek deputy Marinos Sizopoulos, without the corresponding upgrade in services. On the contrary, there were still long waiting lists – some over six months – to see specific specialists. This point was made by several deputies who also spoke about “abuses” that were a big cost for the system and the need for more effective monitoring mechanisms.

There was also a need for transparency in payments, in line with EU recommendations, said Greens deputy Charalambos Theopemptou, who pointed out that at the HIO no detailed information was given about who was being paid, in what direction the money moved and when. He was not the only deputy to highlight the importance of transparency and accountability as the best ways of applying the brakes on those abusing the system. 

The abuses are inevitable considering the sheer volume of the medical transactions and the huge amount of money at the disposal of the HIO. There will be countless unnecessary but costly tests (labs and diagnostic centres are springing up in every neighbourhood) being carried out, many unnecessary operations (because the bed rate paid by HIO is much higher than for non-interventionist care) and many more visits to specialist doctors than are medically justified.

It would be unfair to blame doctors and clinic owners exclusively for these abuses, which are a threat to the long-term sustainability of Gesy. Patients are also responsible for demanding unnecessary tests and referrals to specialists and threatening to change personal doctor if they are not satisfied. Because people contribute to Gesy on a monthly basis they demand every type of care and treatment going, regardless of what their personal doctor might think. This also puts pressure on the system is and partly responsible for the six-months’ waiting time to see a specialist.

Gesy has served the people well even though the system has weaknesses. It is important that these are recognised because they need to be tackled systematically and without let-up if they are to be restricted. And now is a good time to do this as there are large amounts of money flowing into the system thanks to full employment and rising wages. This will not always be the case, and there could be a period in the foreseeable future when the HIO must cope with a smaller budget. It would be much easier to do this if in the meantime abuses have been minimised through greater transparency and more effective monitoring of medical transactions.

This is how we can keep Gesy robust and healthy.