Formula used by NHIH limits elderly patients' access to private oncology treatments

The National Health Insurance House has introduced a controversial formula that determines whether private providers can participate in national health programmes for chronic conditions, including oncology. This measure particularly affects elderly people, who represent the most vulnerable group when it comes to cancer.

The new rule operates on the basis of a complex mathematical equation that calculates whether there are sufficient public providers to meet the needs of patients within a given county. If the result is positive, private clinics may be contracted; however, if it is negative or zero, patients are restricted to state hospitals only.

For elderly cancer patients, this formula can mean the difference between life and death. Time is of the essence in oncology, and delays in treatment can significantly reduce survival rates. An elderly person who receives a cancer diagnosis should be able to begin treatment immediately, rather than waiting for a bureaucratic formula to decide whether they can access private services.

The impact on vulnerable elderly people

Senior citizens are the most affected by this measure, as they represent the age group with the highest incidence of cancer. The public healthcare system is frequently overcrowded, with long waiting lists and outdated facilities. Many elderly people have contributed to the social insurance system for decades and should have the right to choose their own healthcare provider.

The private healthcare sector accounts for approximately 78.5% of specialist clinical service providers and offers modern equipment, high-performance laboratories, and oncology centres equipped with state-of-the-art technology. For a senior citizen diagnosed with cancer, access to these facilities can be vital.

The new rule disregards the reality that in oncology, neurology, or cardiology, every day's delay can result in irreversibly lost function or even the difference between life and death. An elderly person cannot afford to wait months before beginning treatment.

The need for a fair market

The solution would be to create a level playing field, where public hospitals and private providers have equal rights and obligations towards the patient. Senior citizens should be able to decide for themselves where they wish to receive treatment, without being financially penalised for that choice.

Genuine competition in healthcare drives down waiting times, encourages investment in technology, and improves the patient experience — all of which are crucial for elderly people who require urgent, high-quality medical care.