[ad_1]
ACTS Post opinions with a wide range of perspectives to encourage constructive discussion.
In Bulgaria there are enough doctors. But there are no nurses. And the infrastructure is bad. That is why Bulgarian doctors work in much more difficult conditions than many of their colleagues in Europe.
Everyone in Bulgaria repeats: there is no one who treats us. The pandemic recalled something we had known for a long time: the healthcare system is in free fall.
If we look at the details, we will see that the work is more complicated than it seems. In fact, doctors are not cutting back that drastically. The new graduates emigrate, the old ones stay. But it also reduces the population they serve. In 2019, there were only 55 fewer doctors than the previous year. If in Germany there is one for 206 people, in our country the number is comparable: one for 235, that is. more than many EU countries. The problem is that their average age is growing; According to the BMA, a quarter have already passed the retirement age. And the coronavirus turns them into cannon fodder for the infection that primarily attacks adults.
In addition to the discussions, we also learned that our doctors have become temporary workers, following the example of their Polish counterparts, who have been doing it for years. He does what he does, and the weekend arrives and he takes the plane to take a few shifts in Germany and round out his budget for the month. How you keep this pace in retirement, how much your risk of infection increases, I leave it to you.
What is missing in Bulgaria?
The dramatic problem is with the nurses and the rest of the medical staff. At the beginning of the year, it was found that 30,000 employees were missing from the system. Today, most of the employees are also elderly and, moreover, are forced to work in two or three places to survive on their meager wages, which generally do not exceed BGN 1,000. They were protesting, hanging from the windows of the presidency, but no serious action was heard, although the first wave of warnings warned us how far we could go.
Unlike doctors, nurses cannot work as guest workers multiple shifts per month. Their bill comes out only when they permanently emigrate to places where they are paid ten times more than in Bulgaria. As a result, there are 490 nurses for every 100,000 inhabitants in Bulgaria, while the European Union average is around 800. The problem is similar with ambulances, paramedics, laboratory technicians, cleaners, and so on. Added to this is the persistent lack of electronic health cards and digital health care.
What is going to come out? The Bulgarian doctor has to work in much more difficult conditions: writing like a 19th century bureaucrat, making bandages, answering the phone, boiling tools, making financial and accounting accounts. Do you understand why the German doctor in the above figures is more efficient than ours?
By the way, the situation is similar with all specialists in Bulgaria: instead of a hierarchical system of associates that allows him to deal only with the important things that he studied, he has to fight against everything himself (should I say that we in the university? We haven’t been able to trust assistants, research assistants, Internet assistants for a long time?).
My feeling is that this is the case everywhere; Bulgaria does not know how to organize a hierarchical order of responsibilities and the crisis in the current healthcare system makes this clear. Add in the unsupported infrastructure that impacts even the most prestigious medical academy, add all the difficulties to specialize and grow in the profession – you’ll understand why young doctors are on the run.
Along with democracy, a sense of the rights of the patient owed by the health worker has entered our country: every mistake leads to lawsuits and sometimes slaps. Well, the class will be able to defend itself against them, but it will hardly be able to cope alone with the brutal yellow means, which awaken destructive passions, turn doctors into murderers, idiots, greedy people. This attitude is rarely seen in the world.
I dare not give advice on how to reform the system, I only watch the public debate on the subject.
How to solve the problem?
Demographic problems throughout the developed world are solved by importing labor. We do a program aimed at Vietnam or India, we provide conditions for these people to integrate. Well, yes, but national populism prevailed in our country and a taboo was imposed on the issue of migration: we will grow old, we will die here alone, but “clean.”
We can reduce the output of our medical specialists if we drastically increase their salaries (3,000 BGN per nurse, I heard as a proposal). I would add – and improving working conditions, respect for the profession, offering municipal housing to the needy and many other measures. The question is where the money for this will come from. Considering that tomorrow the same problem will appear with the welders, with the police, with the horticulturists.
Consider this comparison. With almost the lowest healthcare costs in the EU, Bulgaria ranks among the top countries in terms of hospitals per capita: 5.2 per 100,000 compared to the EU average of 2.9 (more only in Cyprus). In addition, the trend is to increase approximately one clinic per year. Why is that? Probably because many managers own private clinics that earn well from payments provided by the health insurance fund. Any attempt to rationalize the system has met with fierce opposition from the left and right that some poor people will be left without access to health care. And money continues to flow into numerous rivers and streams. The situation here is reminiscent of higher education: a large number of universities and branches, with students and funding in decline.
I don’t know how this work can be arranged, where will some politicians come from who do not have or do not have relatives who own clinics. Perhaps when we take “strong to die”, we will come to our senses? The helpless rage of the minister, who (self-isolating in quarantine) swears by private hospitals that refuse to fight the Kovid-19, does not seem to inspire me much optimism.
Bulgaria
[ad_2]
