“We are sorry, we are out of medicine”

“We are very sorry Sir, but our hospital has not been supplied with your needed medication…

 We are sorry Sir; you will have to buy this by yourself”

“So I produced some cash, and suddenly the hospital “found” the needed medication”

Sounds familiar? This has a direct effect on you in person…yes you… me… all of us.

The lack of medication in national health institutions is one of the latest disasters of our times. It is a situation which has arisen for many reasons that I cannot go into in this article, but I know that the problem is not about to vanish. The national system cannot cope with rising costs, and the government fails to deal with the growing yearly deficit of the health budget. The terrible effect of the lack of funding on the whole health system has to become visible somewhere… at some point it has to appear. At some point it has to affect us.

When we are prescribed some pills, we tend to ask for the execution of our “contract” with the state. The “deal” was that we would pay our taxes, and the state will care for us in times of medical need. The moment we find out the state has “breached the contract” this is a blatant disregard of those of us who pay our taxes in a timely manner.

Modern times have brought a clear trend in weakened states. A “weak state” is now a common phenomenon. Many of the countries in the Americas, in South Asia, and in Africa, are suffering as a consequence of the reduction of the power of the State. The result is the rise of private legal or semi legal organizations, some of which have the ability to influence the quality of the State’s medical care.

The late “Arab Spring” is a good example to see what was left out of the states and countries whose peoples have claimed their liberty. I do not know what liberty was granted to the divided societies of Iraq, Egypt, Syria, Lebanon, Chad,Mali, and Somalia… (to name just a few). The strong old ruling establishment has disappeared, and under that claim for freedom, war-lords and chaos have taken over.

Something of this behaviour is also visible in the countries of Eastern Europe. People from the old generation who sometimes tell you that “The days of Communist rule were better” are those who cannot navigate their way through the new chaotic “democratic freedom”. For the old lady who is refused her needed medication and cannot pay for it, the old establishment was indeed better, at least from her own small perspective.

In terms of medical care, the most worrying aspect of medication management is the appearance of

“Fake-Medication” which comes mainly from Southern Asia. Under generic brand-names it is sold in the West. This is an international-scale crime which has to be dealt with just as we would l deal with drug-smuggling or human trafficking. But, as previously stated, the newer states who cannot put policeman on the street in the certainty that they will not succumb to the occasional bribe, cannot also find the human and financial resources to deal with large scale crimes as “medi-drug” ones.

The commercial world of selling medication is no different from a battle-field, full of falsifications and twists that are somehow legal, but it is a really disorganized battlefield loaded with option and fuelled with a lot of money.

Just like in a battlefield, there are victims here as well.

The Iron fist has to come from the state. The state has to stopthis reality. In this chaotic environment the under budgeted hospital becomeseasy prey to the many conflicting interests of so many persons involved.

All in all, we are over medicated. The shrewd dealers of the pharmaceutical companies are seducing the doctors and hospitals to prescribe medication that very often is not really essential. The current mentality we have is supportive of this. Often I hear of patients trying to convince doctors to prescribe them with antibiotics as the first line of treatment. Our judgment of the quality of our doctor is very often related to the ease with which we can obtain medication we think we need to take.

In this unhappy mix, there is the obvious lack of a managed and responsible control that only a strong institution, like the state, can impose. With the loss of its powers, with the loss of adequate budgeting, the state has cost us the ability to maintain a healthy and well-regulated pharmaceutical supply system. So, at the point where our need for medication and the acknowledgement of the fact that we cannot obtain it meets, the system inevitably collapses.

Solutions? Well, I do not know where to start. The answer to this long and tiring list of problems can serve as the subject of my next articles. But allow me to remind you that, at the end of the day, the responsibility for the health of our loved ones and of ourselves cannot be left to others… certainly not to ”those” others. Health Insurance can be the best way to make sure that you will always have the medication you need – and when you need it. This is because the doctor will be well paid by your insurance policy and they will be free from any financial incentives and temptation that can influence their judgment.

Medical care is a state project… but our health is our life, our health is our business!!!

The article was published on Agerpres.ro –  the expert opinion column: http://www1.agerpres.ro/opinia-specialistilor/2013/11/11/ne-pare-rau

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