The Government of the Republic of Macedonia aims to build accessible, quality and financially long-term sustainable healthcare having the citizens in the center of the healthcare system, and also strengthened sensitivity and responsibility of the individual for his/her own health and the health of the others.
The overload administrative work of the healthcare workers will be decreased, and the care for the patient will be put in attention. The Government will propose annulment of the participation for hospital care. The healthcare system of Macedonia will be connected in an integrated information system, and a net of healthcare institutions will be established which would include full coverage with ambulances, especially in the suburban and rural areas.
In order to cease the outflow of medical staff from the public healthcare, the Government will provide for normal working conditions and higher incomes. Providing higher incomes, bigger chances for specialization and improvement of the conditions for their medical practice, we will make an atmosphere because of which more doctors would like to stay in Macedonia.
Good organization of the healthcare activity is the one that gives advantage to preventive and primary healthcare. In the preventive healthcare, the Government will stand and contribute for: preserving and improving the health of the population, in particular the vulnerable groups (children, pregnant women, old people, chronically ill and disabled people); healthcare education in schools with the aim to adopt healthy lifestyles (appropriate nutrition, physical activity, prevention of tobacco, alcohol and psychoactive substances addictions, prevention of sexually transmitted diseases, HIV/AIDS, and problems related to mental health); broad expert debate for the needs and the benefits of vaccination, along with purchase of quality vaccines. The quality, and not the price, will be the key criteria; enhanced control of the current infectious diseases that have importance for the population’s health; measures and activities in order to decrease morbidity, disability and the premature mortality caused by the most chronically non-infectious diseases (cardio and cerebrovascular diseases, malignant diseases and the diabetes) through promotion of health with organized activities by the Government, the healthcare institutions, non-governmental organizations and citizens associations; strengthening the capacities of the dental healthcare in the system, actually, and not just on paper, implementation of the programs for early detection of malignant disease in order to have a diagnosis in the early stage.
In the primary healthcare system, the Government will work on achievement of the following goals and policies: provision of personal gynecologist for every woman in Macedonia; patients will be registered in doctor’s offices, with determination of maximum number of registered patients per doctor; increase of the per capita points for the personal doctors to 90 denars; introduction of medical map of all existing healthcare establishments in Macedonia and liberalizing the net, that is to take away the minister’s right to give a permission to open a doctor’s office and the Fund’s decision whether to conclude an agreement with a doctor’s office which has fulfilled the working conditions according to criteria that applies to everyone; establishment of a fund for financing treatments abroad for children up to 18 years old which will need to urgently adopt the necessary decisions, free from political and ministers’ pressure. Thus, the healthcare treatments of children in Macedonia will not depend on the humanity of its citizens.
In the framework of its own healthcare policy, the Government will establish a new independent public healthcare institution for urgent medical assistance, which will unite all services of urgent medical assistance, and it will connect all hospitals in the Republic of Macedonia.
The Government will immediately start the preparations for introduction of a free- of-charge hospital treatment for all healthcare insured people. Moreover, a gradual process for increase of basic income of all healthcare workers will be started. The basic income of all healthcare workers will be doubled by the end of the mandate. By the year 2020 the doctor’s income will be at least 100.000 denars, or in precise 1.600 Euros. “My term” will be replaced with a system that guarantees speedy and quality healthcare protection at every level, with precisely determined deadlines and obligations. The new system will dramatically decrease the time for the administrative duties of the doctors.
With regard to healthcare facilities, the Government will work on putting into operation the center for diabetes foot treatment in the framework of the City general hospital “8 September”; opening of the Children’s general hospital in Skopje with an Urgent center; opening of the center for on-time diagnosis and treatment of sexually transmitted diseases with multidisciplinary team with the aim to decrease the complications, such as sterility and malignant diseases; start for reconstruction and equipment (including the necessary staff) of the general and clinic hospitals in Macedonia in order to create university clinics in Stip, Tetovo and Bitola, as well as reconstruction and equipment of the appropriate healthcare houses, policlinics and ambulances (Negotino, Chashka, Rankovce, Lipkovo, Arachinovo, Drachevo, Lisiche, Chair and Novaci). The Government will analyze the possibilities to establish a national cardiovascular center with regional ambition and performances.
The Government will secure construction of a new, modern and functional University clinic center in Skopje, which will guarantee high quality healthcare services to the population in the whole country and it will bring back the concept of a single University clinic center in which the clinics will be functionally connected.
In order to increase the number of medical specialists in the public healthcare, specialization of the best 10 students in every generation will be introduced and the quotas for state specializations will be raised. We will give an advantage to the scarce specializations according to the needs of the healthcare institutions and regions. During the specializations, the doctors who follow them privately, will be entitled to the income and insurance guaranteed as minimum wages for a general practice doctor.
Tightly cooperating with the parents’ associations of children with rare diseases and special needs, the Government will propose new legal regulations, which will enable the care for this sensitive category to be more comprehensive and more reliable.
Concerning dental medicine, the Government will initiate increase of the payment per capita for the personal dentists and basic free-of-charge dental packages for children up to 18 years of age.
The Government will work on overcoming the situation of lack of prescription medicine after the 15-th day in the month and provision of greater accessibility of medicine. A system will be established which will prevent abuse of prescriptions and fake spending of the monthly quotas for medicine supply. Timely supply of insulin for the diabetes patients on a yearly level will prevent the transfer of the patients from analogue to human insulin. The list of medicine that are burden of FZOM will be reviewed once per year, with input of new medicines on the list and guaranteed presence of all medicine from the essential list of medicines. The Government will stand for having at least one kind of oral contraception to be put on the positive list.
The Government will provide pharmacy subsidies in the rural areas through three-year payment of a defined rent for business premises, subsidies of the healthcare and insurance costs in the period of three years and compensation of travel expenses in case the pharmacist lives at a distance greater than 20 km from the pharmacy.
A new framework will be defined regarding the parallel import, appropriate to its role and function, and in compliance with the model that is applied in the EU countries and a more objective, transparent and internationally confirmed methodology for establishment of single medicine prices in the Republic of Macedonia will be introduced.
In the selection of medicine and public announcement for their supply, representatives of relevant citizens associations in the area of health care protection will join the management bodies, as well as, representatives of the clubs and ill people associations (diabetes, hemodialysis, hypertension, breast cancer, HIV infection), as well as patients with rare diseases, patients from marginal communities and patients with special needs. Hence, exactly the final beneficiaries and selection of quality medicine will control the state and medical aid devices will be secured at the best price.
The Government will urgently prepare an Action plan for financial consolidation of the public healthcare institutions, as well as a proposal for using the private hospitals resources for services that the public healthcare lacks at the moment through conclusion of agreements.