On the cusp of the new year, the scene changed in hospitals that had experienced pivotal moments in recent years, and some of them were forced to merge with university hospitals to avoid closure. Those concerned do not hide their fear that some other hospitals will falter and search for logical solutions that were essential to avoid a new health disaster.
The contradiction paints a new picture of the confusion that the hospital sector is witnessing, and what confirms this picture is the disparity occurring between the opening of new hospitals, the most recent of which was the opening of STMC Hospital, or what was previously known as St. Therese Hospital, managed by Dr. Fadi Hashem, and the mergers that have affected 7 hospitals so far, while The head of the Private Hospitals Syndicate, Suleiman Haroun, expresses his fear that other hospitals will falter in light of the ongoing challenges in the hospital sector.
The Minister of Health in the caretaker government, Firas Al-Abyad, insisted on sending a message, as he confirmed during the opening of the STMC Hospital, “There has often been talk in recent years that the hospital sector faces the risk of collapse, and that hospitals may close. However, what is happening is the opposite, such as Saint Therese Hospital today, and soon Saint Louis Hospital will be opened, in addition to the opening of other hospitals with the help of university hospitals, in parallel with the restoration and expansion of departments in other hospitals.”
However, the minister does not deny that the biggest challenge “is the inability of many to recover.” This fact was talked about by Haroun as a fundamental problem facing hospitals in particular.
Since the economic crisis that struck the country in late 2019, the head of the Private Hospitals Syndicate has issued more than one warning about hospitals’ inability to withstand for long. The decision to close threatened some small hospitals, and others were looking for a new investor to find a solution to their financial difficulties, but they remained steadfast until the economic and social situation exploded.
7 hospitals were merged with university hospitals to avoid their closure: Saint Charles Hospital, Qurtbawi Hospital, Tal Shiha Hospital, Al-Salam Hospital in Qobayat, and the Family Hospital in Zgharta, all of which were merged with Hotel Dieu Hospital. The hospital that merged with the American University Hospital in Beirut is KMC Hospital, while Al-Barji Hospital in Koura (northern Lebanon) joined Saint George Hospital in Beirut.
The medical scene has penetrated the Lebanese scene with movements of doctors and nurses from time to time to raise their voices about the collapse of the medical sector and the migration of its staff on the one hand, and the interruption of medical supplies and medicines on the other hand, especially cancer and chronic diseases. The situation was oscillating up and down in the healthcare sector with a relentless effort to avoid a complete health collapse.
Both the head of the Private Hospitals Syndicate, Suleiman Haroun, and the director of medical care at the Ministry of Health, Dr. Joseph Helou, share that “the main problem is the financial crisis, and that any solution must be financial so that the hospital sector can continue and continue.”
Relying on raising the budget of the Ministry of Health to match the high costs that accompanied the economic crisis, which made the cost of some medical procedures difficult for a large segment of the Lebanese.
Big differences before and after the crisis
In a simple approach to what was the case before the economic crisis, Helou points out that “the Ministry of Health’s hospital budget was about 330 million dollars annually, but today it does not exceed 20 million dollars. This reality prompted many to resort to the Ministry, after we were covering about 47 million percent of the Lebanese population, the percentage rose to 65 percent as a result of the economic crisis that prevented many from bearing these financial burdens.”
For example, the cost of open-heart surgery was about 13 million and 600 thousand Lebanese pounds, and the patient paid only 750 thousand pounds as a difference. Today, the Ministry has sought to double the cost to 8 times, i.e. 100 million Lebanese pounds, which is equivalent to $1,000 today, which means that the value of $8,000 previously is equivalent today, with the collapse of the operation, to $1,000 to cover the cost of the surgery at the Ministry’s expense.
This major collapse in the currency has weighed heavily on citizens in the first place, as they resorted to primary centers and government hospitals to alleviate the burden of the hospital bill.
In parallel, the head of the Private Hospitals Syndicate, Suleiman Haroun, points out that the hospital bill in dollars has declined by 25 percent from what it was before the crisis, but in return we have witnessed a steady increase in the cost of medical supplies and electricity. However, hospital prices with insurance companies, for example, do not exceed 65 percent of what they were before 2019, which means that the pricing is 35 percent lower.
On the other hand, the cost of medical supplies increased by 15-20 percent, as did the correction of this equipment.
Since the financial obstacle is the basis of the problem in the health sector, those concerned are counting on raising the budget of the Ministry of Health, and this is what Al-Helou confirmed in his speech, saying: “We are promised to multiply the tariff that was multiplied by approximately 8 and a half times, and to raise it 50 times, meaning that the ministry’s dollar will be at the price of 75. Therefore, the patient pays the difference in the range of 15-20 percent of the hospital bill.”
If we do not get the budget we hope for, we are facing a disaster. We will witness a complete collapse of the hospital sector and we will not succeed in developing the sector as we should, and reducing the difference in the hospital bill for the citizen.
Two main challenges
Haroun and Al-Helou agree on the financial problem that played a major role in exhausting the hospital sector. In Haroun’s opinion, hospitals face two main challenges:
* The first challenge – financial difficulties: The tariffs of the guarantor bodies (especially the Ministry of Health and Social Security) are still low compared to the increase that hospitals have witnessed since the beginning of the crisis until today. As a result, the financial differences are large (thousands of dollars), making many people unable to bear these costs.
Therefore, the solution is to secure the necessary funding to keep up with the current cost (from medical supplies to employee wages, electricity bill, TVA…), especially since hospital income has decreased and thus this is what explains the financial difficulties facing hospitals today.
* The second challenge – human crews: The migration of doctors, nurses and specialists in various medical fields, including technicians in the laboratory, radiology and others, who have experience and competence, and the use of recently graduated people and training them from scratch so that they can take over the vacant positions.
Lack of some specializations
On the other hand, Al-Helou believes that “increasing the budget of the Ministry of Health will help improve the health and hospital situation and encourage medical and nursing staff to return, especially since we suffer from a shortage in some specialties, including pediatric heart surgery, as there is currently one doctor in Lebanon working in 5 hospitals to compensate for the shortage.” The result.
Some hospitals also suffer from a shortage of head neurosurgery. Accordingly, he asserts: “We need to provide incentives for doctors and specialists to return to Lebanon, and a large number of them have returned.”
Helou sums up the crisis by saying: “The stability of the political situation contributes directly to the stability of the financial situation because the latter is linked to politics.”
Will the health sector breathe a sigh of relief in 2024 with its fairness in the budget and the raising of tariffs from the guarantor bodies, or will it be the beginning of a more severe health crisis whose price will be paid by the citizen, who may be unable to receive health care as a result of the exorbitant hospital bill?
2023-12-29 09:59:00
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