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Kıbrıs’taki sağlık sistemi reformu: Denemeler ve iyileştirmeler

Yıl 2018, Cilt: 5 Sayı: 1, 1 - 6, 31.03.2018

Öz

Kıbrıs, son 25 yıl boyunca bu görev için harcanan önemli mali kaynaklara, 2001 Ulusal Sağlık Sigortası Kanunu’nun
(USSK) kabulüne ve Sağlık Sigortası Organizasyonu’nun (SSO) kurulmasına rağmen, sağlık reformlarını hayata
geçirmeye çalışmakta başarısız olmuştur. Bu makale, önerilen sağlık sektöründeki reformların uygulanmamasının
nedenlerini ortaya koymayı ve engellerin üstesinden gelmenin olası yollarını önermeyi amaçlamaktadır. Yazarlar,
Cumhuriyet Başkanları ve Sağlık Bakanları, başlıca kurucu figürler ve sendikalar ve işveren temsilcileri, sağlıkta
baskı grupları, sağlık çalışanları gibi politikacılar ile yarı yapılandırılmış görüşmeler yoluyla bu soruna niteliksel bir
yaklaşımda bulunmayı seçmişlerdir. Buna ek olarak, veriler Kıbrıs Sağlık Bakanlığı kayıtlarından alınmıştır.
Bu çalışmanın sonuçları, Kıbrıs’ta hükümet veya devlet mekanizmasının önerilen Ulusal Sağlık Sigortası Kanunu’nun
uygulanabilir olduğuna inanmadığını ve dolayısıyla Kıbrıs’taki Ulusal Sağlık Sisteminin uygulanmasıyla çıkarları
tehdit altındaki paydaşlarla çatıştığını ortaya koymaktadır. Sigorta şirketleri ve yüksek gelirli doktorlar, hükümetler
üzerinde Ulusal Sağlık Sigortası Programı’nın uygulanmasını durdurmak için baskı uygulamaktadır. Vergi kaçakçılığı,
Sağlık Sigortası Organizasyonu’nun teknik uzmanlığının eksikliği ve inceleme döneminde gerçekleşen üç büyük
olay, yani Avrupa Birliği’ne giriş, Avrupa Ekonomik Alanı (AEA) ve mali kriz, tüm girişimlere son vermiştir. Gerekli
fonlar sağlanmış olmasına rağmen altyapı geliştirilememiştir. Sonuç olarak, devlet hastanesi özerkliği kurma planı,
reformları uygulamak için yapılan tüm girişimlere son verilmiştir.

Kaynakça

  • Τheodorou, Μ., Charalambous, C., Petrou, C. and Cylus, J. (2012).CyprusHealthsystemreview, in Health Systems in Transition 14(6).Available athttp://old.hpi.sk/cdata/Documents/HIT/Cyprus_2012.pdf
  • Petmesidou, M. (2012).Annual National Report 2012: Pensions, health care and long-term care. European Commission DG Employment, Social Affairs and Inclusion.
  • Cylus, J., Papanicolas, I., Constantinou, E., Theodorou M. (2013). Moving forward: Lessons for Cyprus as it implements its health insurance scheme. Health Policy, 110, pp. 1-5.
  • Charalambous, C., and Theodorou, M. (2013). Systems for the provision of oral health care in the Black Sea countries Part 13: Cyprus. OHDM, 12(1), pp. 3-8.
  • Amitsis, G., and Phellas, C. (2013). Country Document: Pensions, health and long-term care - Cyprus. European Commission DG Employment, Social Affairs and Inclusion. Available at http://pensionreform.ru/files/67436/2013.%20ASISP.%20Country%20Document%202013%20-%20Cyprus.pdf
  • Mladovsky, P., Srivastava, D., Cylus, J., et al. (2012). Policy Summary 5: Health policy responses to the financial crisis in Europe. World Health Organization.
  • Planning Bureau. (2012). Cyprus National Reform Programme 2012. Europe 2020 strategy for smart, sustainable and inclusive growth. Republic of Cyprus
  • Cylus J, Mladovsky P, McKee M. Is there a statistical relationship between economic crises and changes in government health expenditure growth? an analysis of twenty-four European countries. Health Serv Res. 2012 Dec;47(6):2204-24. doi: 10.1111/j.1475-6773.2012.01428.x. Epub 2012 Jun 7.
  • Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D, Mackenbach JP, McKee M.Financial crisis, austerity, and health in Europe. Lancet. 2013 Apr 13;381(9874):1323-31. doi: 10.1016/S0140-6736(13)60102-6. Epub 2013 Mar 27.
  • Christou, O., Ioannou, C., and Shekeris, A.I. (2013). Social Cohesion and the State in times of austerity - Cyprus. Friedrich-Ebert-Stiftung.
  • Kontopoulos A., and Kontopoulou, E. (2014). The place of private health insurance in Cyprus and its prospects. International Journal of Caring Sciences, 7(2), pp. 390-405.
  • Antoniadou, M. (2005). Can Cyprus overcome its health-care challenges? The Lancet,365, pp. 1017-1020.
  • Planning Bureau. (2008). Lisbon strategy. Renewed national reform programme of the Republic of Cyprus. Republic of Cyprus.

Cyprus’ health system reform: Trials and tribulations

Yıl 2018, Cilt: 5 Sayı: 1, 1 - 6, 31.03.2018

Öz

For the past 25 years, Cyprus has been unsuccessfully trying to implement healthcare reforms, despite the significant
financial resources spent on this task, the enactment of the 2001 Law of the National Health Insurance Scheme
(NHIS) and the establishment of the Health Insurance Organization (HIO) with the mission to implement a National
Health Insurance Scheme in the country. This paper aims to trace the causes of failure to implement proposed
reforms in the healthcare sector, and suggest possible ways to overcome the barriers. The authors have chosen
to take a qualitative approach to this investigation through semi-structured interviews with politicians such as
Presidents of the Republic and Ministers of Health, main constituent figures and representatives of trade unions
and employers, pressure groups in healthcare, health workers. In addition, the data were drawn from the records
of the Cyprus Ministry of Health.
The results of this study reveal that no government or state mechanism in Cyprus has believed in the viability of
the proposed NHIS and thus has been in conflict with stakeholders whose interests have been threatened by the
implementation of the National Health System in Cyprus. Insurance companies and doctors with high income,
exercise pressure on governments to withhold the implementation of the National Health Insurance Scheme. Tax
evasion, the lack of technical expertise by the HIO and the three major events that took place during the review
period, namely the accession to the European Union,the European Economic Area (EEA) and the financial crisis,
put an end to all attempts to implement the reforms. Although the necessary funds were made available, no
infrastructure was developed. As a result, the plan to establish state hospital autonomy was proclaimed the most
important barrier to the implementation of the reforms.

Kaynakça

  • Τheodorou, Μ., Charalambous, C., Petrou, C. and Cylus, J. (2012).CyprusHealthsystemreview, in Health Systems in Transition 14(6).Available athttp://old.hpi.sk/cdata/Documents/HIT/Cyprus_2012.pdf
  • Petmesidou, M. (2012).Annual National Report 2012: Pensions, health care and long-term care. European Commission DG Employment, Social Affairs and Inclusion.
  • Cylus, J., Papanicolas, I., Constantinou, E., Theodorou M. (2013). Moving forward: Lessons for Cyprus as it implements its health insurance scheme. Health Policy, 110, pp. 1-5.
  • Charalambous, C., and Theodorou, M. (2013). Systems for the provision of oral health care in the Black Sea countries Part 13: Cyprus. OHDM, 12(1), pp. 3-8.
  • Amitsis, G., and Phellas, C. (2013). Country Document: Pensions, health and long-term care - Cyprus. European Commission DG Employment, Social Affairs and Inclusion. Available at http://pensionreform.ru/files/67436/2013.%20ASISP.%20Country%20Document%202013%20-%20Cyprus.pdf
  • Mladovsky, P., Srivastava, D., Cylus, J., et al. (2012). Policy Summary 5: Health policy responses to the financial crisis in Europe. World Health Organization.
  • Planning Bureau. (2012). Cyprus National Reform Programme 2012. Europe 2020 strategy for smart, sustainable and inclusive growth. Republic of Cyprus
  • Cylus J, Mladovsky P, McKee M. Is there a statistical relationship between economic crises and changes in government health expenditure growth? an analysis of twenty-four European countries. Health Serv Res. 2012 Dec;47(6):2204-24. doi: 10.1111/j.1475-6773.2012.01428.x. Epub 2012 Jun 7.
  • Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D, Mackenbach JP, McKee M.Financial crisis, austerity, and health in Europe. Lancet. 2013 Apr 13;381(9874):1323-31. doi: 10.1016/S0140-6736(13)60102-6. Epub 2013 Mar 27.
  • Christou, O., Ioannou, C., and Shekeris, A.I. (2013). Social Cohesion and the State in times of austerity - Cyprus. Friedrich-Ebert-Stiftung.
  • Kontopoulos A., and Kontopoulou, E. (2014). The place of private health insurance in Cyprus and its prospects. International Journal of Caring Sciences, 7(2), pp. 390-405.
  • Antoniadou, M. (2005). Can Cyprus overcome its health-care challenges? The Lancet,365, pp. 1017-1020.
  • Planning Bureau. (2008). Lisbon strategy. Renewed national reform programme of the Republic of Cyprus. Republic of Cyprus.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Derleme
Yazarlar

Andreas Polynikis Bu kişi benim

Giagkos Lavranos Bu kişi benim

Yayımlanma Tarihi 31 Mart 2018
Kabul Tarihi 27 Şubat 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 5 Sayı: 1

Kaynak Göster

APA Polynikis, A., & Lavranos, G. (2018). Cyprus’ health system reform: Trials and tribulations. Sağlık Akademisyenleri Dergisi, 5(1), 1-6.
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