From inCyprus - Local News 20 May 2017
As Cyprus gets ever closer to the introduction of an all-new National Health System (NHS), many members of the public still have a lot of questions about exactly what it will mean for them.
Saturday’s edition of Phileleftheros outlined some of the most frequently-asks questions, and provided answers to them.
The NHS is an independent and autonomous insurance fund in which contributions and / or other income will be paid to healthcare providers (doctors, nurses, clinics, pharmacists, hospitals, etc.) to provide health care services to the citizens of the Republic of Cyprus.
2. What is the goal of the NHS?
The goal of the General Health System (NHS) is to design and deliver a modern and integrated health system that responds to the expectations of the citizen, reflecting modern perceptions and realities.
The NHS is designed to be universal, socially-oriented, supportive, integrated and accessible.
Universal means that all employees and those with an income with contribute
> Socially-oriented means that that it covers the entire population, without exceptions, discrimination and regardless of their financial capacity.
> Supportive means that contributions are determined on the basis of income, regardless of what the beneficiary has or will have in health services.
> Integrated means that the health care system covers all basic health services with the possibility of participation of all providers both from the private and public sectors.
> Accessibility means that the health care system will allow the recipient patient to freely choose the provider that will provide them health care services, without barriers or restrictions.4. Who will manage the NHS:NHS management is the responsibility of the Health Insurance Organisation (HIO). The HIO is a legal entity governed by state law, run by a board of eleven members composed of representatives of the government, employers and employees. In the amending bill that was recently sent to the Legal Service, the patient’s participation in the Board of Directors is added with one representative.
The representation in the Management Board of the Organisation of all social partners provides the NHS Fund with autonomy and shields it from political interventions, as consensus is required of all parties when making any decisions.
The representation in the Management Board of the Organisation of all social partners provides the NHS Fund with autonomy and shields it from political interventions, as consensus is required of all parties when making any decisions.
Beneficiaries of the NHS are all citizens who have their habitual residence in the areas controlled by the Government of the Republic and fall into one of the following categories:
(A) Cypriot citizens
(B) European citizens residing and working or having acquired the right of permanent residence.
(C) Third-country nationals who meet the requirements of national law.
(D) Those dependent on the above
(A) Cypriot citizens
(B) European citizens residing and working or having acquired the right of permanent residence.
(C) Third-country nationals who meet the requirements of national law.
(D) Those dependent on the above
The right to NHS health services is independent of the payment of a contribution. NHS beneficiaries are defined on the basis of the criteria mentioned above. Services will be provided on the basis of needs and not on the basis of the citizen’s economic potential. Therefore, even non-income citizens (unemployed, children, students, soldiers, public benefit recipients, etc.) will have equal access to health services.
The NHS provides comprehensive health care to its beneficiaries. All services are covered by physicians in out-of-hospital settings, medicines, laboratory and imaging (x-rays, MRIs, CT Scans), in-hospital care, and other health services detailed in the NHS bill.
(The beneficiary will have the right to receive the above services from the hospital, diagnostic center, chemist, pharmacy of his choice, provided that the centre is contracted with the NHS)
Moreover, with the implementation of the NHS, all beneficiaries are able to receive health care services in all EU Member States on the basis of Regulation 883/2004 on the coordination of social security systems and Directive 2011/24 / EU on the rights of Patients in cross-border healthcare.
(The beneficiary will have the right to receive the above services from the hospital, diagnostic center, chemist, pharmacy of his choice, provided that the centre is contracted with the NHS)
Moreover, with the implementation of the NHS, all beneficiaries are able to receive health care services in all EU Member States on the basis of Regulation 883/2004 on the coordination of social security systems and Directive 2011/24 / EU on the rights of Patients in cross-border healthcare.
Health services within the NHS are offered by all public and private health providers contracted to the Health Insurance Organisation. These providers must meet the minimum requirements on their qualifications, infrastructure and equipment.
9. How are health services obtained?
NHS recipients are entitled to access to health services by first selecting a General Practitioner (GP) and registering on their list. It is noted that for children a Paediatrician is chosen by their guardian.
The recipient patient first has to visit the GP who is responsible for making the first diagnosis and providing the appropriate treatment. In cases where specialised services are needed, the GP issues a relevant referral. The referral refers to the specialty of a physician, e.g. a visit to a cardiologist and the patient will be able to visit the cardiologist of his choice.
The recipient patient first has to visit the GP who is responsible for making the first diagnosis and providing the appropriate treatment. In cases where specialised services are needed, the GP issues a relevant referral. The referral refers to the specialty of a physician, e.g. a visit to a cardiologist and the patient will be able to visit the cardiologist of his choice.
In cases where a GP is absent for a long period of time, such as attending educational seminars abroad, rest leave, etc., another GP who will replace him during his absence. The absence of the GP and the arrival of his / her replacement will announced to the people enrolled with the absent GP.
The beneficiary has the right to change their GP every six months.
The beneficiary has the right to change their GP every six months.
11. Is there a right to free choice?
A basic parameter of NHS is the patient’s choice of health care provider. Whether by referral or direct access, the patient is free to contact the health provider of his choice.
Access to health services by Specialists is done through a referral issued by the GP.
Nonetheless, recipients have the right of direct access, to dental practitioners for preventive dental care, without the provision of a referral by the GP, as well as gynecologists and obstetricians for the treatment of gynecological issues for women who have reached the age of 15, as well as Accident and Emergency Departments.
In all other cases, recipients will still have direct access to a specialist without a referral, provided that they will pay a specific amount of money both for the services they will receive from the specialist and for all ancillary health care services (e.g. medicines, clinical examinations).
Nonetheless, recipients have the right of direct access, to dental practitioners for preventive dental care, without the provision of a referral by the GP, as well as gynecologists and obstetricians for the treatment of gynecological issues for women who have reached the age of 15, as well as Accident and Emergency Departments.
In all other cases, recipients will still have direct access to a specialist without a referral, provided that they will pay a specific amount of money both for the services they will receive from the specialist and for all ancillary health care services (e.g. medicines, clinical examinations).
These incidents will be evaluated by a specialised committee and, depending on the committee’s findings, will be sent to specific foreign centers. The costs will be covered by the NHS.
In addition, NHS beneficiaries retain the right to receive healthcare in EU Member States on the basis of Regulation 883/2004 on the coordination of social security systems and Directive 2011/24 / EU on the rights of patients in cross-border healthcare health care.
In addition, NHS beneficiaries retain the right to receive healthcare in EU Member States on the basis of Regulation 883/2004 on the coordination of social security systems and Directive 2011/24 / EU on the rights of patients in cross-border healthcare health care.
14. Are patients with chronic ailments covered?
One of the main goals of the NHS is to meet the needs of both chronic patients and those suffering from serious and rare diseases. Coverage includes the full range of NHS services. The aim is to strengthen the quality of primary care, the implementation of preventive and screening programs as well as guidelines and protocols to provide upgraded quality of service.
15. How will NHS contributions be collected?
In order to avoid any public inconvenience and with the aim of low administrative costs, existing infrastructures operating in the Republic are utilised. In particular, the mechanism of the Social Insurance Services, the Tax Department and the Treasury Department is used to collect the contributions. Depending on the type of income of the individual, the contributions are collected by the above services / departments.
Wage contributions are withheld from employers and paid on a monthly basis to the Social Insurance Services as is also currently being applied and for collecting the contribution for the purposes of the income tax. The Social Insurance Services then submits the contributions to the NHS fund.
16. Are the NHS contributions also a “tax” for the household?
On average, the contribution paid for the NHS is not an additional tax for the household. All available statistics show that today (without the NHS) the budget of each household is burdened by about 5% to 7% for health costs. They also show that this burden is now in place in an unpredictable way and in an unpredictable extent. In particular, today a household may be called upon to pay an excessive amount to treat a family member who was suddenly diagnosed as suffering from a serious illness.
The NHS provides lifelong financial protection for every citizen by paying contributions based on his income (if any) and not on the basis of his unpredictable needs for health services. The NHS contribution is such that the burden on the family budget is on average significantly lower than the current burden.
It should be noted that the amount of the contribution is calculated by a percentage of the total remuneration of each individual with a maximum sum of salary of €150,000.
17. Are there supplementary payments to the NHS?
Supplementary payments are predetermined amounts, which the citizen will know about in advance, and paid to the provider when receiving the health services from the beneficiary, such as visits to doctors, medicines, laboratory tests. Supplementary payments are a measure that applies to all national health systems and aims to promote responsible use by beneficiaries of health services covered by the system, to control abuse and contain system costs without affecting access, if necessary, as there will be a ceiling on the supplementary payments.
Based on the percentages of contributions as determined by agreement with the social partners, the total amount to be collected annually from the beneficiaries’ supplements will not exceed €60 million. With this data, it should be expected that the amount of the supplement for each service will not be much higher than or at about the level as the current fees in public hospitals.
Annual ceiling of supplements:
· General population: €300
· Low-income pensioners: €75
· Minimum Guaranteed Income recipients: €75
· General population: €300
· Low-income pensioners: €75
· Minimum Guaranteed Income recipients: €75
That is, any beneficiary belonging to the “general population” category will not pay annually any supplementary payments in excess of €300, regardless of whether he will need and will receive additional services. The same will apply to the other two categories of beneficiaries, low pensioners and aid recipients and those receiving the GMI, who will only pay up to €75 a year.
In the design of the NHS, best international practices and recommendations of the EU are being implemented to reduce the cost of the system and to improve the quality of health services, such as the introduction of a GP, the implementation of guidelines and protocols, the use of an integrated computer system etc.
The holder of a private insurance plan is not obliged to terminate his contract. It is up to each citizen to continue, stop or diversify their private insurance plan according to his / her own needs and financial capacity.
20. How do you expect the general population to respond to the implementation of the NHS?
The NHS is an anthropocentric system designed and agreed with the social partners and other stakeholders and voted by the Parliament, with a focus on serving the patient and empowering the patient.
· Lifelong financial protection against the need for costly health services.
· Equal access to health services irrespective of economic status.
· Access to an expanded list of pharmaceutical products.
· Reduce waiting lists by exploiting the productive potential of the public and private sectors.
· Increase patient-based options at healthcare provider level.
· Upgrading the quality of the services provided.
· Upgrading primary care for early diagnosis and more effective treatment.
· Provision of information and complaints through call center operation.
· Protection of patients’ rights through the appointment of an independent supervisor, who will examine patients’ complaints concerning the HIO and / or health providers.
· Creating an electronic dossier with full access for the patient.
· Acquiring the right to receive healthcare in all countries within the EU.
21. Will I have the right to choose medicines?
Yes. The HIO will offer beneficiaries more than one choice in their respective pharmaceutical formulations. The HIO’s prescription will automatically include all the formulations currently included in the public hospital prescription. Subsequently, all importers, dealers, etc. will have the right to import their formulations into the HIO’s Schedule upon request / approval. The HIO will offer the simplest supplement (around €1 per pack) on the lowest priced formulation. If the patient chooses one of the other drug options, he will pay only the difference in price. That is, if the formula that the HIO offers costs €5 and the formulation that the patient chooses costs €8, the citizen will pay only €3, the difference between the two prices.
It is important to note that the recipient will be able to obtain his medication from the pharmacy of his choice.
It is important to note that the recipient will be able to obtain his medication from the pharmacy of his choice.
The NHS is mainly funded by contributions where there is triple participation between employees and those with other income, employers and the state.
(A) Calculation is based on Net Income
(B) Income refers to the amount reported and used for taxation purposes by the Internal Revenue Department
(A) Calculation is based on Net Income
(B) Income refers to the amount reported and used for taxation purposes by the Internal Revenue Department
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