This issue has been raised before. For instance, Deputy of the Jogorku Kenesh Dastan Bekeshev proposed creating a state charitable fund for those in need of treatment abroad (not only for children). The Ministry of Health also discussed the creation of a fund to assist children with rare diseases at the request of former Minister Erkin Checheybaev.
The editorial team of Kaktus.media reached out to experts and representatives of patient organizations for comments regarding this idea. The questions posed concerned the necessity of such a fund, its functioning, and the possibility of improving the level of medicine in the country to avoid the need for treatment abroad.
Gulmira Abdyrazakova, Director of the "Together Against Cancer" Foundation
- The idea of the fund has potential, as it is successfully implemented in Russia and many European countries. However, we lack clear mechanisms for raising funds (for example, SMS contributions or tax benefits for businesses). We and other funds have tried to address the issue of social contributions from businesses, but mobile companies refused due to the lack of a mechanism.These are systemic problems.When creating the fund, several questions need to be resolved:
- Who will receive assistance?
- What diseases will be funded, and what is the age of those in need?
- What criteria will determine the funding?
- How will the amount of assistance be distributed?
There is also the question:
- Will there be state support in the form of medication provision for orphan and oncological diseases?
Olga Trukhanova, Director of the "First Children's Hospice" Charity Fund
- It is nice to see that deputies recognize the problem, considering the number of posts about fundraising on social media.This initiative is not new, and it is quite justified: there are cases where helping people within the country is impossible due to a lack of technology, specialists, or equipment. In such situations, the state must have a support mechanism so that families do not face their troubles alone.
If the fund is created, it must operate under strict rules and with clear selection criteria, only for those cases where it is proven that treatment in the country is impossible.
In my opinion, it is much more important to invest in the development of medicine within the country.If we simply pay for treatment abroad without developing our healthcare system, we will never be able to break free from dependency. We all remember the COVID-19 pandemic when borders were closed, and treatment could only be done at home, under the conditions we have.
Money should stay in the country, as it is much easier to be treated at home: loved ones are nearby, familiar food and water. My grandfather, who went to Germany in the 90s, always said that Kyrgyz doctors are among the best. If they received the same funding as in Germany, they would have no equals.
Beremet Baryktabasova, Head of the Independent Medical Trade Union and Expert in Evidence-Based Medicine
- The initiative of the deputies has once again attracted the attention of the public and medical professionals, who are dissatisfied that it is the deputies and high-ranking officials who receive treatment abroad, instead of working on improving medicine in the country. The creation of a fund may lead to it being used only by them and their relatives.Nevertheless, the government has long discussed the idea of creating a fund under the Ministry of Health to raise funds for expensive operations and technologies. For example, medications for children with SMA and other rare diseases, organ transplants (kidneys, liver, heart, lungs), neurosurgical and cardiac surgical operations that are not included in the state guarantee program. However, in Kyrgyzstan, such initiatives often fail because the costs of operations and the management of patients with serious illnesses have not been adequately calculated.
All calculations are done by guesswork, touching only on certain stages of treatment without considering rehabilitation. When the full cost, including preoperative preparation and postoperative care, is considered, it turns out to be significantly higher.
These funds should not be sent abroad, where prices are exponentially higher. It is better to invest them in your own medicine!There are also clear corruption risks associated with affiliation with foreign clinics, where patients are effectively "sold" for treatment abroad for huge sums.
How does this happen? In recent years, the popularity of medical tourism has significantly increased, with patients forced to go abroad for high-tech operations that can save lives.
Medical tourism is not regulated in the country.Lawyers note that this is the patient's choice. The Ministry of Health does not track how many patients go abroad, with what conditions, and what happens to them after operations.
Local and foreign companies strive to attract patients to foreign clinics, profiting from this. The current number of intermediaries, both legal and illegal, seeking to direct patients abroad, is impressive. Even employees of state institutions can direct patients abroad, receiving good dividends. They often devalue the work of local institutions, scaring patients with high mortality rates and claiming that they will not survive in Kyrgyzstan, leading to patients being easily "recruited" for treatment abroad.
There are entire medical centers engaged in the "recruitment" of patients for foreign clinics. There are funds operating in the country that organize the transportation of patients to countries such as Turkey, Uzbekistan, Kazakhstan, and Russia! It is necessary to control such funds and close those that not only deplete the resources of the state and patients but also discredit local hospitals where such operations are performed for free and with quality.
Recently, the Ministry of Health reported a significant outflow of cardiac surgery patients (both children and adults) to Uzbekistan, especially from the southern regions (Batken, Osh, and Jalal-Abad regions). It later became known that operations that are performed for free at the National Center for Cardiology and Internal Medicine for up to 6 years cost between $800 and $1,400, while private clinics send patients abroad for $60,000. Meanwhile, Turkish colleagues claim that the cost of such operations there is $15,000.
Private and state clinics invite foreign surgeons to Kyrgyzstan, paying them between $12,000 and $20,000 per operation. If we compare even the lowest foreign assistance with the most expensive operation at the National Center for Cardiology and Internal Medicine, the difference is at least $5 million, which is overpaid annually by charitable funds, the state, or the patients themselves.
Moreover, the level of competence of invited foreign surgeons is not regulated, and they work in the country on a trust basis. Often, the arrival of surgeons is not accompanied by master classes to train local specialists. There are no credit hours or certifications for local doctors.
Foreign funds can also bring their students and assistants to gain experience on our patients. Thus, local healthcare ends up as a supplier of patients for foreign clinics, rather than as a developing system.
Thus, the state, on one hand, allows citizens to receive highly qualified operations and expensive medications for free under the state program, while on the other hand, spends huge sums on treatment abroad. Intermediaries create additional financial burdens for patients, which are 8-10 times higher than expenses in state institutions.
It is urgent to address the regulation of issues related to fundraising and "medical tourism" at the government and parliamentary level. It is important:
- To determine which high-tech interventions are performed in the country and with what results, and which are absent or have low effectiveness. Information should be available on the websites of the Ministry of Health and the State Mandatory Health Insurance Fund;
- To inform patients about complex diseases and operations to monitor the situation;
- To introduce control and restrictions for medical tourism, prohibiting the receipt of dividends for referrals to foreign clinics;
- To conclude contracts with foreign specialists, considering the conditions of their work;
- To create a state account and control over cases of intervention by foreign doctors;
- To organize certified master classes for local doctors and internships abroad;
- To document and certify the skills of local specialists;
- To invest in the development of local medicine, enhancing the qualifications of personnel and providing high-tech interventions according to international standards.
