The dentists were humiliated: the people themselves did not want to take those checks

On this and other problems, the affected dentists Delfi spoke with the president of the Board of Auditors, Alvydas Seiki.

Here are excerpts from the press release of the Lithuanian Chamber of Dentists:

“For more than 15 years in Lithuania, he operates in a private dental practice independent of the Lithuanian National Health System (LNHS), but must meet and implement the requirements of the health system and its institutions. The constant increase and therefore Excessive document preparation does not improve the quality of dental services at all, but only burdens the administrative burden.

The LNSS is the exclusive property of state institutions or private dental institutions that have concluded contracts with territorial health insurance funds (ICD), the number of which is less than 20%. All public funds for dental care are distributed annually only in this sector.

Media authorities are increasing the high prices of dental services, but no one explains to the public that the price a patient pays in a public institution does not absolutely reflect the actual value of the service or what he generally pays in a dental institution. private.

Private medical institutions do not receive charity, nor are funds from the European Union available for the purchase of equipment. Private dentists and oral care professionals have to pay for everything: premises, equipment, materials, additional training, themselves. However, Lithuanian dentists constantly strive to ensure quality treatment and keep up with the world level. <...>

State contribution to the population so far oral health prevention programs – nonexistent. Pediatric dentists do not receive the cooperation of state institutions or at least a more appropriate approach to caring for a child’s mouth.

<...> Prevention of preschool-age children is not funded at all, although at this age both training of parents for proper dental care and healthy nutrition of children and employment of oral health specialists are very important to work. preventive.

<...> For many years, the country’s dentists have been in the limelight of the State Tax Inspectorate (STI) and the Financial Crime Investigation Service (FNTT) regarding the amount of suspicious wages. However, research and analysis of the fiscal environment in the dental sector conducted thus far has not been methodically related to the actual workload of dentists (full-time, 0.5, 0.25, or hourly employment), nor has it been evaluated different forms of activity (UAB, MB, IĮ) The requirements and peculiarities of financial accounting were not evaluated, as well as the different mechanisms to calculate the prices of services (when medical care is provided with private funds from patients and funds of the PSDF), the different VAT deduction requirements were not taken into account, etc. All these research deficiencies fundamentally distort the image and cast an unwarranted shadow on the dental sector. How much can dentists blacken? Defame the name of all dentists who work honestly and pay taxes?

About 80 percent. Lithuanian dentists work in private. According to A. Šeikus, there are 14 dentists for every 10,000 inhabitants in Lithuania, and the European Union average is 7 dentists for every 10,000 inhabitants. population.

“Based on the number of dentists, as well as twice the European average, this should show that there is a lot of competition in Lithuania.” Of course, there are problems, we have told the Ministry and other organizations many times that there is a very big gap, “said the Speaker of the House Council, emphasizing that dentists are concentrated in the largest cities in Lithuania: Vilnius and Kaunas. .

“There are as many as 36 dentists in Kaunas for 10,000 people, imagine what concentration and how dentists” catch “their patients,” said A. Šeikus.

Probably little will be new to this: Admission to dentistry is a great competition, so this program is chosen only by those who graduate with the highest grades, and this sometimes has to pay the best scores for their studies.

“Those people are studying, they start working and suddenly they become thieves, tax evaders, etc. I can’t believe that a person who has finished school in their tens, studies at a university, has a higher education, suddenly become a tax evader, etc. – Šeikus was outraged by such an idea – Clearly, the problem is that economics is taught very little in higher education and does not teach entrepreneurship; since access to the public sector is practically impossible since that goes down and down, everyone enters the free market. Prices can’t regulate, there’s a free market, fierce competition. Even more so because the science of dentistry is quite expensive, which is why students have taken so many credits Young people start working, they can’t find work anywhere, then they have to buy premises, an office, hire an accountant, an assistant, an administrator, a registrar. She is the only person na that quenches that bureaucratic bubble. They are getting credits and everyone wants to give them away as soon as possible. “

An interview with A. Seiki.

The dental profession is not easy: you need to study hard and there is a lot of competition when you enter, and even more so when you work. Still, it seems like if it was very bad, maybe so many people wouldn’t choose this profession?

If there are around 3,000 dentists in Lithuania, and about 18% work in the public sector, then those offices are established whenever possible.

When people learn, they have high expectations. It is rumored in society that prices are high and that it can be a good business, but it is not. Many dentists go abroad or work just a few hours in different clinics, looking for clients.

What are the problems facing the dental community? How could the state contribute to your solution?

Fifteen years ago, when the Court was established, it performed functions delegated by the state. By May 1 of this year, the current government had destroyed that self-government, handed over licensing functions to the state, although it was only a cost to the state and produced nothing.

ITS control. The Tax Inspection from the first days of independence … It is strange that the inspection of the ITS, the Financial Crime Investigation Service (FNTT) and other structures usually begins in the run-up to the elections. Since dentists seem to take a lot of money from people, the state says: here, we will put a little pressure on dentists here, we will start to take punitive actions, and people, Lithuanian citizens, seem to like it. But in reality people don’t have an education, they don’t understand the value of dental services as much as they really cost. It seems to everyone that dentists take a sum of money and keep it all for themselves. None of that: pay taxes on that amount.

Also, dental work is not just about dentistry – the dentist works with dental technicians, plus he pays the labs for the work done, and with electricity, it all comes together. <...> Clearly, there are major clinics, which do massive implants, and so on. This is what they earn. But since the ITS says that individual institutions do not file taxes, there is nothing like it. Under current law, sole proprietors declare otherwise, and that the data is not published, but after all, they shake everything up, roughly dividing the dentist, receptionist and cleaner salaries, and say the salaries are low.

This is not the case, a thorough study needs to be done and no one says that the STI does something wrong, but the methodologies are not the most correct. We are now preparing an appeal and we will present, apparently next week, an appeal to the Government to shed light at least fairly and objectively on the situation in the field of dentistry, as there can be no mere shadow.

There are many problems. For example, indicating VAT. VAT is lower for public medical institutions that have contracts that belong to the National Health System. Private – bigger. It also affects either 5 or 21 percent. The state should help solve these problems.

Also, the media writes: Dentists don’t write checks. It doesn’t make sense that dentists don’t write checks. People might say: I don’t need a check, maybe it’s even cheaper, etc. There are problems on both sides. The state could do this: People hand over checks and, when taxes need to be reported, return that part to people for the cashed checks. In this regard, the contribution of the state would be necessary not only in the dental sector but also in the medical sector, as well as in all other sectors, as is done with nurses.

In the report he distributed, he writes that the state’s contribution to prevention overall is too small. Especially when it comes to dental services, he also says that children’s dental health is tragic. The dentist’s offices are full. Why so much chaos?

In 2016, the National Oral Health Program was approved, there was collective, public and individual prevention in schools and preschool institutions. We have many hygienists who can contribute and do. It was estimated how many people in the treatment facilities should be in the prevention program. But the program remained in the drawers until 2020 and nothing happened.

In the Chamber press release, he writes: since no political party takes it seriously, the media and patient organizations must ask themselves whether the Lithuanian state is willing to pay for quality general dental and medical services. How should that question be asked? Or maybe Lithuania is not ready yet?

I think Lithuanian citizens are ready to get very good service. Sometimes I hear that during the Soviet era dental services and perhaps even better were, and inexpensively, the dental composition of iron or gold and could live. Now that neither the gold nor the iron teeth are gone, everyone wants to receive the highest quality services and such opportunities are available. But those services cost money, because Lithuania does not produce drills or dental materials, everything has to be bought and must meet European standards.

Our specialists are also prepared according to the European university level, but people say they are very expensive services. So why are you going to Lithuania for dentures and dental treatment? Looking at the cost of dental services, materials, equipment, and the price compared to Europe, we look great in terms of value for money. And people want quality, and the state needs to think about it and contribute so that they don’t have iron teeth again.

<...> There must be three participants: the dentist, the state, and the patient. If the three were reasonably and logically united, I believe that the quality and availability of dental services would be balanced.

And how do you find the balance between those three countries?

Educate and educate people, our Lithuanian citizens. Now, I am strictly speaking, only about the dental segment, you must be broader, but you must be educated, be responsible and honest with yourself and with the state. The state gives you money, use it all, bring it in, and tell the children to check, to heal. I went to a private tooth, groomed, take the check. An article appears and then people write comments: they don’t give me a check. I can’t believe it won’t budge. If you need it, how can you not give? If you go somewhere in the store, you may not accept the check. But there is no way not to give maliciously. If a person were a citizen, they would ask for a check and receive it. I suspect that people are cunning and provoke: oh, I don’t need it, maybe it’s even cheaper. And start negotiations. It may be so.

As I understand it, you have an action plan, you will send a document to the Government. Who said it?

We were in a meeting with the ITS. We discussed the situation, the criminal actions they were taking, declared some of our positions and decided to cooperate. The ITS has promised to participate in the seminars that we organize. <...>. However, that educational work must be in our community. Dentists are not aware of the reasons why they are not catching up, if any, where wages are low, but we will try to increase the reasons and The need for it to be over. Perhaps there are reasons, and we will try to resolve this. We will now do 2-3 surveys and provide data.

What do you expect from the government?

You will want to do it together and talk. Now that is not at all. What 3 has no connection. We also make suggestions, but there are no reactions.