Hospitals announce “mass suicide”: closure within three weeks

Only three weeks were granted by the State Hospital Owners Syndicate before it closed its doors to patients. This time, the decision is decisive and irreversible. This was confirmed by Suleiman Haroun, captain of the hospital owners. Three weeks after that … the flood that the union drew some of its features will come at its press conference yesterday. She announced the end of work in many departments in hospitals, and directs the latter to limit her work to receiving emergencies and those that threaten the lives of patients. But it remains a watershed stage between the state’s decision and the next “pedal” that hospitals will take, while declaring that failure to respond to the demands will result in “almost complete closure of most departments, except for the dialysis and chemotherapy departments”. It is the last stage of the mass suicide that the union decided unilaterally, especially since it knows that this period is not sufficient to devise solutions in a country that stands on the brink of collapse. The union also recognizes that the battle is unequal in the face of an impotent state, and the sick are mostly poor, who are now poorer with the suffocating financial crisis. Thus, the union is fighting a battle against people. And if some of the demands are right, but closing the doors of hospitals is “a serious matter,” says the head of the Parliamentary Health Committee Assem Araji.However, there is no other option for the union, according to Haroun, because “reaching the complete collapse is around the corner” for two main reasons, the first of which is chronic and relates to the financial dues of the outstanding hospitals under the state, and the second is an emergency imposed by the financial crisis and the crazy increase in the cost of hospitalization. In the first reasons, Aaron tells the long story of dues that are repeated every year. This time, the crisis started in 2018 with some guarantors (military doctors and the Internal Security Forces), and does not end with the first six months of this year. While the Ministry of Public Health announced sending a file of dues belonging to hospitals for the remainder of last year, in addition to a file of a financial advance for the first three months of this year, the hospitals have not yet received news from the Ministry of Finance on these payments. Even if the ministry decided to exchange, “It will not be a month from now,” says Haroun. As for the claims of the military medical and internal security forces, “We have not received any penny for 5 months, and the dues for part of the years 2018 and 2019 have not yet been paid.” In addition, the union “informed the two parties that it was not possible to send the dues file two or three months ago, which means that 4 months ago, nothing can be talked about.”
The state has more than two billion dollars in hospitals, in addition to the two military doctors whose numbers have not been announced yet. The idea of ​​installment of these payments, as the National Social Security Fund does through monthly advances, has recently been raised, but there is no official answer to that yet. Therefore, “what remains for us to bear”, Haroun decides, describing the stage today as “the most dangerous, because the dues lost 80% of their value being in the Lebanese pound” at a time when the cost of hospitalization and the subsequent increases in medical supplies and equipment increased. The battle, here, is losing, in terms of the difference between the operational cost and the tariffs currently in force, especially that “the official guarantors place their bills in pounds based on the exchange rate of a dollar at 1,500 pounds, while the dollar today touches the 10,000 thousand pounds.” Hence, the demand to amend these tariffs, even though the sources of the Ministry of Health have confirmed that it is impossible today to take such a step, in order to avoid the injustice of citizens who get paid in pounds.
Another cause for the union’s fatigue is the price list approved by the guarantors for medical supplies. This regulation has not changed in nearly 20 years, which “makes the difference between the price of the largest in the list and its price today.” What makes matters worse is the dollar crisis, and the decision of the Bank of Lebanon regarding the import of medical supplies, which left a margin of 15% “We have to buy it at the market exchange rate.” Hence, Aaron estimates the difference in the obligatory price “between the official price determined by the guarantors and the agent at about 80%.” This is a new crisis that is beginning to show its “symptoms” with the dollar crisis. As hospitals receive their dues and hospitalization fees in pounds, while “all of their liabilities are in dollars”. As a result, “the operating cost of the hospitals increased by at least 50% from what they were before the current crisis, which led to a significant imbalance in their financial balance”, at a time when the number of patients decreased by the same percentage (to less than half) due to price increases and the Corona crisis .
It remains that the whole country is caught in this unequal equation: commitments in dollars, salaries, and dues in pounds. This is not a single sector crisis, and it is thus “larger than the ministry,” according to the Ministry of Health sources. Therefore, a decision like the one announced by the union is not required today because it is a decision that “does not bear”, but rather “patience is a goal for people at this stage.” It was the same thing that Araji would have liked the union to take: “Quirky so that the Parliamentary Health Committee can find satisfactory solutions.” According to Araji, the first was to give the committee a margin of time “to complete what we started to reduce the harm to the health sector.”

The Health Committee will launch the support of the Banque du Liban to fully import medical supplies

No solutions will come in one go, but rather attempts to ease the crisis. Therefore, “the Ministry of Health is doing what it can.” Including, for example, “the approval by the House of Representatives of an advance of 450 billion pounds to calm the conditions of hospitals,” and work to prepare a study for the ministry to purchase medical equipment and supplies to be delivered to hospitals at a subsidized price. This step, according to the sources, “takes approximately two months to enter into force, thus relieving hospitals of the greed of importers.”
In the same context, the Parliamentary Health Committee will hold an emergency meeting tomorrow, in continuation of two previous meetings, in order to formulate the final recommendations in preparation for transfer to the relevant authorities, especially the Presidency of the Council of Ministers, the Bank of Lebanon and the Ministry of Health. Among the recommendations proposed is the request to the Banque du Liban to release medical supplies from Resolution 530 (85% official exchange rate and 15% the market exchange rate), provided that drug smuggling or monopoly in the sale of drugs should be seized on the basis of the black market exchange rate, and the collection of hospital dues with rationalization The latter to spend, and to communicate with the customs administration to specifically control drug trafficking.