From March 16, 2021 until the end of that year, the Health Insurance Fund (FZO) sent several letters to the Ministry of Finance and Social Welfare, pointing out the alarming situation in the health system and financing problems, with a request to provide additional money in order to this system functioned smoothly, but there was no positive response to those letters from the ministry.
During that period, the director of the FZO was the current Minister of Health Dragoslav Šcekić while the Minister of Finance and Social Affairs was then Milojko Spajic.
"Vijesti" has access to that documentation.
Šćekić told "Vijesta" yesterday that it was clear that the Ministry did not want to talk to them at the time, and Spajić that they did as much as they could at that moment.
According to the latest calculation of the Ministry of Finance, the outstanding liabilities of the FZO are around 65 million euros, and this money for debt settlement will be provided in the rebalancing of the budget, which the Government should determine today and send to the Parliament for adoption.
According to the documentation, on March 16, 2021, in a letter to Spajić, Šćekić indicated that the spending limits for the FZO for that year in the preparation of the budget are low and that financing problems may arise during the year, i.e. that there may be a halt in the supply of medicines and an increase in outstanding obligations all the basics.
After that, on August 11, 2021, he sent a letter to Spajić in which he asked to look into the possibility of providing the Fund with additional money for spending, because the data for the first seven months of that year show that by the end of the year, less than 60 million euros will be missing to settle obligations provided that the epidemiological situation does not worsen. According to that calculation, Montefarm needed 32 million for medicines and medical devices, 11 million for gross earnings, 650,38 thousand for treatment of medical waste, eight million for treatment outside the system of public health institutions in Montenegro, for prescription drugs (private pharmacies ) five million, for expenses for laboratory material three million, for the development and maintenance of software 166 thousand euros.
Letters and emergencies
In that memo, it was stated that 2021 million was planned for Montefarm for 68,39 and that 58,14 million had already been spent in seven months, that 17 million was intended for private pharmacies, of which 12,7 was spent in seven months and up to 4,2 million remained at the end of the year, 3,6 million had already been spent on laboratory materials at the end of the seventh month, and three million were missing by the end of the year...
In the same letter, Šćekić informs Spajić that, in addition to this missing money, the Fund receives daily requests from public health institutions to provide additional money beyond the budget. For examples, he states that the general hospital in Bijelo Polje asked for 179,69 thousand to pay the debt for the purchase of oxygen, the special hospital in Brezovik asked for 1,6 million for the purchase of drugs for oncology patients, the hospital in Bar asked for help in financing the construction of an oxygen substation with supporting equipment for the distribution of medical oxygen (60.000 euros) and 46.000 for the purchase of two pallets of one-ton liquid oxygen tanks for optimal functioning, while the Cetinje hospital requested money for the construction of an oxygen substation and costs for additional work because it is organized in three shifts ( 29.000 euros). Spajić did not respond to this letter.
On the same day, August 11, the ministry received a letter in which the Fund stated that Montefarma needed 4,14 million due to the increased consumption of covid drugs, which was not planned in last year's budget. It is indicated that this procurement should be urgent. On August 17, Spajić replied that "the ministry is of the opinion that the money needed for this procurement should be provided from the money planned for the Fund by the law on the budget for 2021".
On September 2021, Šćekić wrote an urgent letter to Spajić in which he again indicated that it is necessary to provide additional money by the end of 30, as well as for the extraordinary procurement of medicines for Montefarm, but the minister did not respond to that either. An emergency on September 2021, XNUMX was also written.
After that, Šćekić writes a letter to Spajić on October 20, in which he again warns about the Fund's problems and asks for a meeting to familiarize the minister and his associates with the problems of the health system, but Spajić does not respond to that letter either.
Request for a meeting
"The operation of the Fund in 2021, in addition to the outstanding obligations as of December 31, 2020, which amount to about 40 million euros, additionally burdens the reduction of the Fund's budget by about 10 million euros compared to the planned money that was expressed through the draft budget. The outstanding obligations during the current year (2021) have increased and will increase until the end of the year in view of the ongoing pandemic. This results in a lack of money in positions where payments are made for dispensing prescription drugs (private pharmacies), treatment outside the system of public health institutions in Montenegro, treatment of medical decline, material costs, software maintenance, medicines and Montefarma medical devices. Looking at the state of finances and the dynamics of spending, we turned to the Ministry with a request to provide the missing money by the end of this year on August 11. On the same day, we sent another request to provide money to Montefarm, which was not planned in the budget for 2021. On September 29, we sent a request to provide the missing funds for the payment of due claims for private pharmacies for July 2021, and on October XNUMX, we addressed the request to provide the missing money for the payment of due claims for Montefarm", the letter says.
What is common to the aforementioned letters that were sent is that, Šćekić states, we did not receive feedback from the ministry regarding whether a decision was made on our requests and whether the requested money will be provided by the end of this year, and if we and received an answer, it was such that we were instructed to divert the missing funds from the positions where we provided savings.
"We inform you that it is not possible to settle the missing obligations from the positions where we provided savings. The management of the Fund, aware of the seriousness in which the healthcare system finds itself, tried several times directly and electronically to schedule a meeting with responsible persons in the Ministry of Finance in order to present the financial situation and challenges faced by the entire healthcare system in direct communication. Hereby, we kindly ask you to schedule a meeting at a time of your own choosing to inform you and your colleagues about the current state of the FZO's finances," says the letter, which has not been answered, as well as the letter dated October 26.
An urgent request was also sent on December 27 to pay two million euros to pay private pharmacies for dispensing prescription drugs, which was not answered.
Šćekić: The warnings were not heeded
Šćekić officially told "Vijesta" yesterday that these documents can be seen as a serious warning to the then Minister of Finance, Milojko Spajić, about all the possible consequences of neglecting the needs of the health system, which were not respected, but were even more brazen than what was done in the previous ten years, and 200 million in revenue was stolen from the FZO.
"It can be seen from the documentation that there was no desire to discuss or take into account the opinion of the fund management. It can also be seen through the emergency rooms that there was no payment dynamics, but the situation in the state budget was deliberately concealed, behind the backs of the healthcare system. Only people who do not have elementary knowledge and emotions towards citizens and the state can do that," Šćekić said.
He said that the management of the FZO made serious savings and interventions, and that if it hadn't been for that, the debt would have been higher, as well as that they were fighting with "tycoons and conceited minister Spajić" for healthcare. Šćekić said that it was more important to make a marketing move for the Podgorica elections than to take care of the future of the state and the basic segment of the system such as healthcare.
Spajić: We did as much as we could
"Vijesti" also contacted Spajić yesterday, who said that the Fund responded to emergencies when they saw how much savings they had from other positions, and we transferred some 20 million to them in November and December.
"We did as much as we could at that moment. We had about 305 million euros in the budget for 2021, which is slightly more than 2020, and we added another 20 million to repay debts, so we spent 325 million. And at the end of 2020, we gave some 20 million to cover debts. Since we became the government, we have spent about 340 million on health care, and as for emergencies, everyone sends them non-stop. Everyone is sending for more money, and we have a budget, we work according to it, and when we find savings in other positions, we transfer from those other positions to the positions we can", said Spajić, who claims that for healthcare "what comes from the reserve, what from of the regular budget, a total of around 2021 million euros was given in 370, and that they increased the funds in the worst crisis that hit the Montenegrin economy".
He said that it would be good if the Ministry of Health and the FZO announced how much has been spent in the cumulative amount since the beginning of this year from the 350 million budget of the fund, as well as that the FZO is a long-standing problem of uncontrolled spending and inherited debts from the DPS period.
According to unofficial information, at the end of 2020, according to the Government's conclusion, the FZO received less than seven million.
Due to the pandemic, costs are rising, and less money is planned in the budget
On March 16, 2021, in the preparation of the budget for that year, Šćekić sent a statement to Spajić on spending limits, in which he pointed out that it is not usual for the budget for the health system to be set at a lower amount than the execution in the previous year.
According to the revised macroeconomic and fiscal policy guidelines for the period from 2021 to 2023, the spending limit for the FZO for 2021 was 290,9 million, and the expenditure for wages was 121,62 million.
"The spending limit for 2021 was set at an amount lower by 1,73 million compared to the rebalancing of the budget for 2020 (289,23 million), and by 10,88 million lower than the execution of the budget for 2020 (301,84 .XNUMX million). It is not usual for the budget for the health system to be determined in a lower amount than the execution in the previous year, especially in the conditions of the coronavirus pandemic when costs in the health system are growing enormously, and on the other hand, income from other sources (income from the public health institute, from the provision of services of occupational medicine...) are not realized or are realized to a reduced extent", the letter states, where it is warned to take into account the two most important items: expenses for salaries and medicines and medical devices.
In the letter, it was stated that the FZO believes that it is not good for the Government to reduce the budget for the health system in the current health situation, in which the health system operates in complex conditions, that is, to project it approximately at the level of the previous (2020) year, and consumption is significantly higher than in the previous year and such a trend continues in the first quarter of 2021.
"We ask you to consider the possibility of increasing the spending limit for the health system, that is, of enabling the Fund to propose a budget based on real needs, because otherwise the functionality of the health system will be jeopardized," the letter reads, among other things.
Spajić and Milatović gave their word and did not keep it
The public pharmacy institution Montefarm announced yesterday that, as they stated, "we will explain to the experts the basic settings of the health system, which they found when they appeared on the political stage as actors in the episode "Experts at work in the 42nd Government of Montenegro".
Montefarm reacted to the recent announcements of the "Europe Now" Movement regarding the current situation with the FZO. Although they did not name the experts, Montefarm alludes to Spajić and former Minister of Economic Development Jakov Milatović.
"The health care system has been systematically collapsed since 2000, and it has been turned into a specific rachomon, the sole purpose of which was to transfer money from the state coffers into private pockets. This is how the FZO was constituted, which does not even have its own giro account, and supposedly manages 335 million euros", the announcement states.
Montefarm states that the experts should explain how it is possible to manage any financial resources without their own giro account, and that there is no need to comment on the impact of their cancellation of healthcare contributions on the work of the FZO.
"Rather, it will be that the FZO served you for the manipulation of financial resources and playing "little gods" where, according to your own judgment, you allocated funds for the needs of the unfortunate plebs. You ignored all the expert assessments of FZO and Montefarma, as well as numerous emergencies and statements about the real needs of the health system, i.e. the citizens of Montenegro. You completely ignored all the warnings that this financial policy will lead to the devastation of Montenegrin healthcare. A classic example of this relationship is completely ignoring previous debts and transferring them to the next period. Such a gambler's approach to public finances has led to an incredible burden on FZO and Montefarma and the impossibility of these two institutions operating normally", they stated from this institution.
For an example of how the debt problem was solved, Montefarm states that the outstanding debts in 2021, which were due at the end of that year according to the supplier Glossary, were 15 million.
"At your insistence, they were transferred to 2022 through factoring with a firm promise that these funds will be planned in the 2022 budget. Of course, none of your promise. At the beginning of November 2021, at your initiative, the government adopted a conclusion on the expansion of the public procurement plan in the amount of 43 million euros, translated into simple language on the purchase of medicines and consumables in that amount. The funds were supposed to be paid in the last quarter of 2021, and half of it, and the other half in the first quarter of 2022. These funds were never paid to Montefarm either, although according to that conclusion and with the consent of the Ministry of Health, the procurement of medicines and medical materials for the entire amount was carried out. , the announcement states.
The announcement also states the following: in order to make no mistake, you paid us seven million from the budget reserves in 2021, but with the blackmail condition that these funds must be paid to only one company.
Montefarm also states that Šćekić is right about everything he said about the health care situation.
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