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Lamborghini on tractor fuel – Midweek

Polling companies conduct surveys that are of more interest to the people of Estonia – the green revolution, security or the migration of frogs. It turns out that he is interested in health. You’re environmentally conscious.

Although – it’s understandable, when the disease is at work, you don’t care about the ongoing war or Toompea’s mud wrestling. Then I would like to get medical help. Which, if the government is to be believed, is absolutely there – at least until you don’t need it.

Yes, there are excellent doctors in Estonia. In Estonia, the majority of nurses have a higher education. We have state-of-the-art hospitals and world-class equipment. Digital registry and great IT solutions. It’s fun to watch, but try to be a part of this beauty – you still have to be in very good health. The majority of family doctors are of retirement age, new ones are not coming on. Nurses run away to wherever the pay is better. Queues for specialists are months long, and you can’t even get to a family doctor, it’s safer to send him a carrier pigeon than to bother him by phone. And across the country there is a cry and lamentation that there is not enough money for health care. Sometimes we lack two hundred million, sometimes four hundred million, thanks to one-time injections from the state budget, we have this beauty standing. Due to the fact that there is a private reception at the patient’s own expense. Although it is as if we paid the social tax. In the same way, there could be a visitation fee in the store – for that, you can look around as much as you want, but if you put some goods in the basket, then you pay separately.

Almost a quarter of a century ago, the healthcare reform turned Estonian healthcare into a market economy. Before, it was a planned economy, managed administratively and financed from the budget – a socialist waste, it did not fit in the new social order. Back then, we all wanted to become capitalists. Today, it has become clear that someone also has to do work.

No one really runs our current health care system. Who is it subject to? The Ministry is welding bills – not managing anything. The Health Board issues operating licenses – it does not manage. The Association of Hospitals is a voluntary association of hospital owners. The Minister of Health has only political responsibility – if something bad happens, he walks away. The Health Fund distributes the taxpayer’s money it receives, it is not its task to manage health care. And who is in charge? But the market leads. All health care providers in Estonia are private legal entities. Even if the hospital is a municipal foundation, it is still private. And obeys no one but himself. Our health care consists of a number of private shops that compete with each other for money from the Health Fund in a weakly regulated market. Using any techniques not expressly prohibited by law.

All this ultra-capitalist stuff is financed in a primitive socialist way – with the solidarity health insurance invented by Otto von Bismarck 150 years ago. It looks like a fancy Lamborghini car filled with tractor fuel. He even drives out of the gas station, but he stops, and immediately there is a group of wise men around who advise – flash the lights, start the housekeepers, move the seat. Well, it’s still not moving, do what you want.

There is nothing wrong with the car itself. Similar healthcare systems work successfully in many other places. On average, 10.9% of GDP is used to finance health care in the European Union, 12.8% in Germany, and 19.7% in the USA. But we only have 7.8%. Of course he doesn’t move. Just as a reminder, 40 years ago in the Soviet Union, 4.7% of GDP was spent on healthcare, what progress. I would skip what pays one percent in money in Germany and what in Estonia – won’t spoil your mood.

Well, but what to do to make the stuff work? Two options – either more fuel or a cheaper car. No one remembers the mechanisms of the cheap planned-administrative health care system anymore, but the fact that the queue for a specialist was three people behind the doctor’s door. Who believes it today. Rather, we are of the mind that we will mortgage the house, let the children starve, but let the car be the last one, so that the neighbor will be green with envy. Well, how can a German Penskar keep a mersu? Its 12.8% of GDP consists of three parts. First of all, joint health insurance, like we have. In addition, employer’s insurance – the capitalist bloodsucker pays it for his workers. And personal voluntary health insurance. All together, it makes several times more per soul than what we can squeeze out of the Health Fund.

Our insurance companies have corresponding insurance packages. In several price levels, even the cheapest partially covers dental treatment, and the full extent of private doctor’s appointment. In other words, it’s not nice to say, he officially allows himself to be bought past the queue. The only thing that stands in the way – the business owner prefers to secure his own well-being at the expense of profit. Does not want to understand that under the conditions of advanced capitalism, the worker is its most important asset. Well, of course, a citizen from whom social tax has already been collected does not want to pay an additional 150 euros per month. Because the car tax is knocking on the door, VAT is rising, prices are rising, everything is recovering, except for health.

What will happen next – I don’t know. In important meetings, health issues are discussed when the hall is already empty. I guess diabetics and hypertensives should be elected to the Riigikogu, they will understand. Because as long as there is health, it doesn’t even occur to you that you might run out one day. At the same time, completely regardless of party affiliation.

Yours, Dr. Viktor Vasilyev


Recommended reading: Chapter IX of the Central Party Program – Health Care Policy

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