The issue of creating such a fund is not being raised for the first time. Previously, Deputy of the Jogorku Kenesh Dastan Bekeshev proposed establishing a state charitable fund for people needing treatment abroad (not only for children). The Ministry of Health has also announced plans to create a fund to assist children with rare diseases under the leadership of the former minister Erkin Checheybaev.
The editorial team of Kaktus.media reached out to experts and representatives of patient organizations for comments. The questions were as follows: "Is such a fund necessary? How should it function? Or should we focus on improving the level of medical services in the country?"
Gulmira Abdyrazakova, Director of the NGO "Together Against Cancer"
- The idea is viable and is already successfully implemented in Russia and a number of European and American countries. However, there are clear mechanisms for fundraising (SMS, promo codes, social contributions with tax benefits) there. We do not have such mechanisms in place, and many funds have tried to address the issue of social contributions from businesses, but mobile operators have refused due to the lack of a clear mechanism.These are systemic problems.When creating the fund, it is necessary to consider:
- Who will the funds be directed to?
- What diseases and what age groups will be covered?
- What criteria will be used for financing?
- How will the amount of assistance be determined?
Additionally, the question will arise:
- Will there be state provision of medications for the treatment of rare and oncological diseases, considering the criteria of the diseases?
Olga Trukhanova, Director of the Charitable Fund "First Children's Hospice"
- It is good that deputies recognize the existing problem, as fundraising is actively discussed on social media.This initiative is not new and is completely understandable: there are people who truly cannot be helped in the country due to a lack of technology, specialists, or equipment. In such cases, the state should have a support mechanism so that families do not have to face their troubles alone.
If the fund is created, it must operate under strict rules and with clear criteria, only for cases where treatment within the country is impossible.
I believe it is 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 remain dependent. We all remember how during COVID-19, borders were closed, and treatment could only be provided in the country, offering the services we have.
Money should stay in the country, and being treated at home is easier — with loved ones nearby, home, familiar food, and water. My grandfather, who went to Germany in the 90s, always said that Kyrgyz doctors are among the best. If they had the same funding as in Germany, they would be unmatched.
Beremet Baryktabasova, Head of the Independent Medical Trade Union
- The initiative of the deputies has once again caused public resonance, as many medical professionals are dissatisfied that the deputies and high-ranking officials go abroad for treatment, instead of developing medicine in the country. The creation of a fund that will only be used by them and their relatives raises doubts.Nevertheless, the government has long discussed the possibility of creating a fund to raise money for expensive surgeries and technologies. For example, for the treatment of children with SMA and other rare genetic diseases, organ transplants (kidneys, liver, heart, lungs), neurosurgeries, and cardiac surgeries that are not included in the state guarantee program. This is common abroad. However, in Kyrgyzstan, such ideas often fail, as the costs of surgeries and treatment for patients with severe diseases are not properly calculated.
Calculations are often done by guesswork, and only individual stages of treatment are considered without rehabilitation. If we consider the full cost with preoperative preparation and postoperative care, not just medications and instruments during the surgery, it results in a completely different amount!
It is not worth sending this money abroad, where the costs are many times higher. Invest in your own medicine!There are also risks of corruption associated with affiliations with foreign clinics, where our patients are "sold" for large sums for treatment abroad.
How does this happen? In recent years, there has been a rise in medical tourism, where patients are forced to go abroad, where complex high-tech surgeries are available, giving them a chance for survival.
Medical tourism in the country is not regulated.Lawyers argue that this is the choice of the patient themselves. The Ministry of Health does not track how many patients go abroad and with what conditions, what happens to them after surgeries.
There are both legal and illegal intermediaries who direct patients to foreign clinics. Even employees of state institutions can direct patients abroad, receiving decent commissions for it, discrediting local clinics and making patients believe that their chances of survival are much lower.
There are entire medical centers that engage in "recruiting" patients for treatment in other countries. And it is such funds that require oversight, as they not only bankrupt the state and families but also discredit local hospitals, where surgeries are performed for free and effectively.
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 turned out that surgeries that are free at the National Center for Cardiac Surgery are free for up to 6 years or the most complex ones cost a maximum of $800-1400, while private clinics send patients abroad for $60,000. Meanwhile, Turkish colleagues claim that such surgeries cost $15,000 according to their price list.
Private and state clinics invite foreign surgeons to Kyrgyzstan, paying $12-20,000 for each surgery. Even comparing the lowest cost of assistance from abroad, the difference amounts to over $5 million a year, which charitable funds, the state, or patients overpay.
It should be noted that the qualification level of invited foreign surgeons is also not monitored. They operate on trust, not based on official documents. Often, visiting surgeons do not conduct master classes to train local specialists, and their skills are not documented.
Moreover, foreign funds often bring their assistants to practice on our patients. Thus, local healthcare becomes a source of patients for foreign specialists, rather than developing its own personnel.
Thus, it turns out that the state, on one hand, provides our citizens with the opportunity to receive complex surgeries and expensive medications for free within the framework of the state guarantee program, while on the other hand, spends large sums on treatment abroad. Intermediaries, in turn, force patients to incur colossal expenses that exceed the costs of state hospitals by 8-10 times.
In this regard, there is an urgent need to regulate issues related to fundraising and "medical tourism" at the government and Jogorku Kenesh levels. It is necessary to:
- Determine which high-tech interventions are performed in the country and with what results, and which are unavailable or have low effectiveness. Information about the cost of services and benefits should be available on the websites of the Ministry of Health and the Mandatory Health Insurance Fund before a patient goes abroad;
- Inform patients about complex diseases and the technical aspects of surgeries;
- Introduce control and restrictions for medical tourism — "recruiting" patients abroad, prohibit receiving dividends for referrals to foreign clinics;
- Sign contracts with foreign specialists, considering their working conditions;
- Maintain state accounting and control over each case of intervention by foreign doctors;
- Conduct certified master classes for local specialists and organize internships abroad;
- Document and certify the skills of local specialists;
- Invest in the development of local medicine, enhancing the potential of personnel and providing high-tech interventions according to international standards.
