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Many people called their personal doctors to enroll for a checkup after the Health Minister Dr. Petar Moskov said that if routine preventive checkups were skipped, there should be a higher health insurance, announced the GPs.

Even now there is a fine of BGN 50 for skipping the annual checkup provided for in the Health Insurance Act. It has not come into practice as no health minister has so far developed a mechanism for its implementation.

“Increasing health contributions is a good step as a disciplinary measure, but all the details have to be taken into consideration,” said Assoc. Prof. Lyubomir Kirov, chairman of the National Association of General Practitioners. He added that everyone had to follow the rules, and the same way doctors were fined for violations, patients should be sanctioned as well. If the raise of health insurance contributions were paid by the insured, not the employer or the state, for example, there would be a real effect. Prof. Kirov explained that the state paid the contributions for pensioners, children, students, the unemployed and if the measures were automatically applied, the sanction would be distributed among all taxpayers.

Over 50% of Bulgarians over 18 do the mandatory annual preventive checkup at their GPs office, according to the Association. In the last Frame Contract the price for the check up had been increased to BGN 10, and the funds set aside for preventive examinations covered just over half of the insured. Separate are the tests that are not provided for independently, but have to be appointed within the common regulatory standard by the GP. If now 2 million people decide to do the examination, for example, this means at least BGN 40 million more, estimated the Association.

Some go on their own initiative, others – due to a particular health problem, and within the visit are done the preventive examinations as well. They include various activities and tests, depending on the age group.

There should be constant awareness campaigns in the media, because things just got forgotten, said Assoc. Prof. Kirov. Despite everything, however, we should not expect that the prophylactics at the GP office could cover the fully insured.

The expectation that preventive examinations could “detect” all diseases is not realistic as well. The point is to get the picture about the risk or the patients with the major diseases: hypertension, diabetes, certain cancers, obesity, etc. They affect more and more young people and it is important to detect them on time – thus preventing complications, improving the quality of life and lengthening the years of working efficiency.

Assoc. Prof. Kirov emphasized that a lot of patients still thought that the GP should look for them for the preventive check-up. This was a delusion left over from previous times. Patients’ health was their personal responsibility, so they had to be the active side. The GP was required only to declare at a noticeable place in his office what kind of preventive examinations and tests are to be done and with what frequency for the insured over the age of 18.

The GPs themselves have remarks on the amount and scope of the planned examinations and tests. Cholesterol and triglycerides tests, for example – a sign of cardiovascular disease and metabolic syndrome – are provided only for men over the age of 40, and then every five years.  Women do this test only after the age of 50 and also with a period 5 years in between.

Assoc. Prof. Kirov explained that this did not suffice and did not provide the sought preventive effect. At the initiative of the Association it was accepted in 2009 that all Bulgarians over the age of 18 should undergo such an examination, and a questionnaire for every patient had to be a filled out during the preventive checkups. Assoc. Prof. Kirov added that they had provided the software and that upon filling out the data from the checkup it immediately indicated the percent of patient risk for various diseases.

The goal was for 2-3 years to cover all and to present a complete picture of the health problems of the population, in order to provide the necessary prevention and therapies. This was done for only 1.5 years, and the opportunities for accurate statistics on people with hypertension, metabolic syndrome, diabetes and other socially significant diseases, were missed.

The technology was developed by Japanese scientists

Japanese scientists have developed technology that allows identifying cancer disease in one drop of blood at an early stage within three minutes, informs RIA Novosti.

The technology was developed by Japanese scientists

“The technology allows to determine malignancy and to identify the early stage of stomach, colon and pancreatic cancer within just three minutes in only one drop of blood. There is no such technology anywhere in the world,” said Katsuyuki Hasegawa – a research fellow in the company MYTECH, which together with the hospital Teyosyu University Syowa developed the new technology.

The company has developed a metal plate with a special composition. When placing on its top a drop of blood from a patient with a malignant tumor, in treatment with ultraviolet and other types of radiation, it lights up, while the blood of a person with a benign tumor does not emit light.
“This is an absolutely new achievement in the world. This method is easy to use and can begin to be used in any hospital even tomorrow,” says Hasegawa.

The World Health Organization (WHO) announced that the viral shedding of the Middle East Respiratory Syndrome (MERS) in South Korea was important, but not a global crisis, reported Reuters the week before. Eight new cases of the disease have been reported in the recent days.

162 people were infected with the virus and 20 people died in the first major viral shedding of MERS outside Saudi Arabia.

The virus came to South Korea after a Korean adult returned from a trip to the Middle East in early May, and the WHO reported an outbreak of new cases was expected, although it seemed that the number of infected people was decreasing.

The members of the emergency committee of the WHO unanimously indicated that MERS in South Korea was not a threat to public health worldwide. Otherwise, coordinated international actions would have had to be organized.
“The problem is of great importance,” said the WHO. “In a world with great mobility the states have to be prepared for the expected possibility of such cases, as well as other serious infectious diseases.”

The organization added that there had been no evidence that the viral shedding was easy and therefore it was not necessary to introduce restrictions on travel to and from the country.

The last eight new cases were more than four and five on the two days before that, while every day the week before that marked more than 10 new cases – the global trend seemed decreasing.

Currently more than 6500 people are under quarantine in South Korea, and the government received criticism for its initial underestimation of the outbreak in the country. “Now all measures to try to stop viral shedding are taken. It is very impressive,” said Keiji Fukida, who was leading the team of the WHO experts, who visited the country last week.

Authorities reported that 19 people diagnosed with MERS, have recovered and have now been discharged from hospitals.

The latest victim of the disease in South Korea was a 54-year-old woman who suffered from bronchiectasis and high blood pressure. Most deaths until now have occurred in people who had pre-existing diseases or elderly people.

All known cases of infection occurred in hospitals. Three hospitals were partially closed and two prohibited medical staff and patients to leave the hospital.

MERS is caused by a coronavirus, similar to the one that led to the worst outbreak of SARS in China in 2003. The majority of infections and deaths have taken place in Saudi Arabia, from 2012 onwards, were more than 1,000 people have been infected, while the victims came to   454.

Referrals will not be necessary for preventive routine examinations starting 2016

Employees are granted one day paid leave every year to undergo preventive medical examinations. The Health Minister Petar Moskov has already held talks with his colleague Ivaylo Kalfin to allow such a change to the Labour Code. This practice exists in all civilized countries like Germany and Sweden, for example. Moskov defended the idea by stating he did not see that Bulgarians were any worse in order to take advantage of such a convenience.

The fine for missing a checkup is BGN 50. However, not a single citizen has been sanctioned.

Starting 2016, when a people went to check their health condition they would not even need a referral from their GP, as every person with healthcare coverage would have an electronic health card. It would hold information about the package of examinations which they were entitled to, Moskov said.

According to him, the division of health services into a basic and additional package would not deprive people of healthcare. The basic package would include all diseases that progress rapidly and could not be put on hold, while the additional package – the ones that could wait, such as cataracts. However, if a person wanted to remove a cataract immediately, they would have to be covered by an additional health insurance fund as well.

At the press conference some days ago the Minister of Health Dr. Peter Moskov stated that at that time the valuation of clinical pathways was like a cat in a bag – no one knew what was in it. He noted that it was unclear how the prices on pathways were formed and what they actually cost. The Minister said he would address a number of issues in that direction – whether the price at that moment ensured a person quality of service, whether the work of doctors was valuated in general, how much went for medical costs, etc.

Dr. Moskov said he was planning to change that and the Ministry was working at that time on the actual evaluation of the activities that would fall into the basic package of health insurance. In his words, it should be clear how much was the actual value of each medical activity, including the funds for the simplest gauze to the most expensive antibiotic. The costs for the use of the equipment and its depreciation would also be taken into account. He said that it was essential to valuate the work of nurses, because at that time that was not calculated in the clinical pathways. Therefore were the planned talks with the BMA where a discussion would be held on how much the average doctors’ salary in the country should be and what were the possibilities to implement the proposals of the professional organizations.

Dr. Moskov said that at that time work was carried out on the evaluation of three disease groups – cancer, cardiovascular and cerebrovascular diseases. He said that the cost of treatment would include all of the above, as well as the cost of consumables.

According to Dr. Moskov such evaluation should be done in relation to the other treatment components – such as the medical devices. He noted that at that moment there was no clarity regarding the basis on which to form their prices and said that would also change. From his words it became clear that the Ministry was preparing a register of products, which would be very different from the current BDA list. A working group would be dealing with this.