The National Health Insurance House (CNAS) is under fire for its proposed changes to the reimbursement rules for private medical services, which could cost patients their freedom to choose healthcare providers. The proposed changes are set to affect reimbursement for critical treatments, impacting national programs for serious conditions like oncology and cardiovascular diseases. Patient associations are vocally opposing these changes, arguing they infringe on the patient's right to select their preferred medical service provider.

The Federation of Cancer Patients' Associations in Romania (FABC) has accused CNAS of attempting to condition access to private healthcare through mechanisms that could restrict access to significant portions of Romania's medical infrastructure. CNAS published the proposed changes at the end of May, describing the project as an effort to introduce an "objective and transparent" formula for assessing when public healthcare providers lack the capacity to meet patient needs. This formula considers factors such as patient numbers from different counties and those seeking care across regions.

However, the patient associations argue that this overlooks the reality that Romania's healthcare system relies on both public and private providers working in tandem. Currently, patients in Romania can choose between public and private health systems if the private providers are contracted with CNAS and have adequate funds for the month. The new proposal, however, stipulates that private services will only be reimbursed if public hospitals cannot accommodate the patients, effectively limiting access to private care.

FABC has been particularly vocal, demanding the withdrawal of the draft order. They insist that any changes should be based on a real impact study conducted in collaboration with patient organizations, healthcare professionals, and all relevant stakeholders. Without this, they argue, the proposed changes could delay treatments and reduce survival chances for patients needing immediate care.

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The changes specifically target two categories of national treatment programs: long-term treatment programs such as oncology and diabetes, and episodic curative programs including cardiovascular diseases and PET-CT scans. The new rules will condition access to private services on the lack of available spaces in public institutions, thereby impacting patients' treatment options. FABC has threatened to take legal action if CNAS does not retract the order, stating they are prepared to appeal to both internal and European courts.

They also published a message on Facebook outlining their opposition to the project, which they claim ignores the necessary role of private providers in the Romanian healthcare system. The Patronage of Private Medical Service Providers (PALMED) echoed these concerns, warning that the CNAS draft order could delay patient treatments and thereby reduce their chances of survival. This sentiment underscores the gravity of the situation, as many patients depend on timely access to treatments that may not be available in public hospitals.

CNAS defends the project by asserting that it aims to create a more transparent system that accurately reflects the capacity of public providers. Yet, the absence of a unitary formula to calculate the real need for medical services in national health programs for patients with serious illnesses highlights the complexities and potential pitfalls of the proposed changes. As the debate intensifies, the CNAS draft order remains in the public eye, with patient associations and private healthcare providers pushing for a reconsideration of the proposed changes.

The next steps remain uncertain, but the stakes are undeniably high for the thousands of Romanian patients whose treatment options hang in the balance.