HOW WAS THE PATIENT MADE FOR THE FAKE
COVID EPIDEMIC?
Dr. M. Uğur YILMAZ
The Turkish
Ministry of Health published a circular on 20/03/2020 and declared State and
Foundation University hospitals and all private health institutions as
“pandemic hospitals” as if coronovirus patients could not apply to private and
public health institutions (SHS/ HCP) previously contracted with SGK/SSI.
https://dosyamerkez.saglik.gov.tr/Eklenti/36907,pandemi-hastaneleripdf.pdf?0
On April 4, 2020,
SGK/SSI also published a new communiqué on the "pandemic".
https://www.resmigazete.gov.tr/eskiler/2020/04/20200404-18.pdf
SGK/SSI: Social
Security Institution (SSI)
SHS: Sağlık
Hizmet Sunucusu= HCP:Health care provider (HCP=a health facility organization
licensed to provide health care diagnosis and treatment services including
medication, surgery and medical devices. Health care providers often receive
payments for their services rendered from health insurance providers.)
With this
communiqué, it has been stated that all procedures used in the treatment of
coronavirus in pandemic hospitals are included in the scope of SGK/SSI
reimbursement.
Anyone who goes
to the University and Private HCP cannot go to the cashier for any transaction
and even talk to a physician without depositing money every time and for every
transaction. Even though it is a pandemic, most of the citizens who know this
situation have started to hesitate to go to the private SHS/ HCP. Citizens know
what will happen to them when they go here.
Both circulars
repeated the "known situation" as if private and university hospitals
were forbidden to care for covid-19 patients before these circulars were issued
and patients could not apply to these hospitals.
With the Health
Transition, the Ministry of Health has ceased to be an institution providing
health services. This ministry cannot provide health services according to its
own mind and independently. Another feature of the transformation is the
privatization of the health market and hospitals and turning the non-private
University and State Hospitals into a commercial enterprise with a tax number
that works for profit and distributes dividends to physicians and top
bureaucrats. These hospitals operate within the SGK/SSI system like private
hospitals, and freely use the health services, drugs, medical supplies and
products included in the SGK/SSI Health Implementation Communiqué. The Ministry
does not have a restrictive and controlling will on physician work. These
hospitals are owned and operated by the state, SSI, which provides services
according to the health market determined by the World Bank and regulates this
service. SGK/SSI is an institution that protects the material interests of all
SHS/ HCP that has signed a contract with it and provides unfair profits to
these institutions. The SSI system, designed by the World Bank, actually
constitutes a health market regulated for the interests of the Medical Cartel.
Article 7.1
of the 2018 Social Security Institution Health Service Purchase Agreement
from Private Health Service Providers. 1 7.1.1 regarding Application and Identification
Procedures. In its article, “SHS/ HCP is obliged to accept the patient who
applies directly or by referral in accordance with the regulations regarding
the application and identification procedures in the SUT2 and the
legislation of the Institution. The reason for not being admitted to the
patient who is not accepted must be notified in writing with the signature of
the SHS/HCP official. It means. BEFORE THESE CIRCULARS, COVID-19 PATIENTS
ALREADY CAN GO TO ALL HOSPITALS CONTRACTED by SSI. The reason for not accepting
patients in Private SHS/HCP is the patient's refusal to pay additional fees,
except for emergency and intensive care patients. This fee is twice the SGK/SSI
reimbursement. This shows that SSI covers 1/3 of the cost of health care.
SUT: Health
Implementation Communiqué. Communiqué containing the services, drugs,
treatments, interventions and surgeries that SHS/HCP can invoice in the purchase of health care
services and the price tables used in pricing them.
7.2.2 of the 2018 SSI Private Health Service Agreement. in the article; SHS/HCP cannot discriminate against any patient in
terms of quality of service or accessibility of services. 8.1.1. in the
article; SHS/HCP has to accept the
patient who applies directly or by referral in accordance with the legislation
of the Institution. It is called. In other words, the patient does not have the
right to reject the patients who apply.
What happens if
Kovid-19 patients who require intensive care and mechanical ventilation are not
covered by SSI or apply to an SHS/HCP
contracted with SSI?: Nothing happens. All SHS/HCP s have to accept
these patients, whether they have a SSI contract or not. At least on paper...
4.3 of the SUT.
In accordance with the article and the circulars of the Prime Ministry 2008/13
and 2010/16, the circulars numbered 2008/13 and 2010/16 of the Prime Ministry
are related to emergency application and intensive care services. According to
article 1 of the circular numbered 2008/13, “Health institutions that are
obliged to provide emergency health services will accept emergency cases
regardless of whether the patient has health insurance or whether he has the
ability to pay and will make the necessary medical intervention unconditionally
and without delay.” It is called. In Article 7: “In no case will it be
questioned how the treatment costs will be met while the emergency medical
interventions and treatments of the patients who apply to the health
institution are made urgently.” In its 9th article, it is stated: “Our citizens
who do not have any health insurance will not be required to pay for the
emergency health services of those who cannot afford to pay.”
As can be understood from these circulars,
all SHS/HCP s available in Turkey have to accept and treat all patients who
require intensive care treatment and mechanical respiratory support.
If this is the case, what do the
statements of the Ministry of Health and the Ministry of Labor mean?
·
The opening of all private hospitals and intensive
care services to covid-19 patients and their assignment as pandemic hospitals
is an application in line with the purposes of unfair profit and profit of
private hospitals. This circular aims to encourage citizens who are afraid of
being robbed to go to private hospitals. Hospitals will be able to go whenever
they want, even without these circulars, as they could before. There's no harm
in explaining it again.
Let's take a look
at the SUT changes published in the Official Gazette dated April 4, 2020:
(According to
ANNEX-2B PER SERVICE PROCESS SCORE LIST (Ex. 01.06.2021))
|
|
|
explanation |
application code |
Price (Turkish Lira)
Price (application code x 0,593)
(excluding VAT) |
|
510021 |
Pandemic care service |
It is billed together with 510010 for treatments for
pandemic cases only during the pandemic. In addition, it is billed with the
code 510090, regardless of whether there is a pandemic phenomenon during the pandemic.
Billed once per day. |
1.124,35 |
666,73955 |
• A pandemic care service code with the code 510 021
has been added to SUT. A statement has been made to those who will receive this
service "regardless of whether there is a pandemic or not". What does
this mean: Private SHS/HCP can
hospitalize the patient who comes in front of him by saying that he is a corona
pandemic patient. This means that SSI will pay 669.33 TL per day to the
hospital for people who do not usually receive any treatment and do not need
treatment.
(*) To determine the transaction price, the
application code is multiplied by the number 0.593.
|
510090 |
Intensive care |
It covers meal, bed, patient visit services. With
this code, monitoring, connecting the patient to the mechanical ventilator,
monitoring with the ventilator, nebulizer, oxygen therapy and deep tracheal
aspiration are not billed separately. |
221,85 |
131,55705 |
• In the meantime, with 704 942 code and immune plasma
supply and application code, 781,615 +62.52 TL VAT included=844.14 TL payment
will be possible. Amount that can be paid with pandemic care services:
1513.47 TL
·
Bu arada 704 942 kodu ile immün plazma tedarik ve
uygulama kodu ile de 781,615 +62.52 TL KDV dahil=844,14 TL ödeme
imkanı verilmiş olacaktır. Pandemi bakım hizmetleri ile
birlikte ödenebilecek tutar: 1513,47 TL
|
704942 |
Immune plasma supply and
administration |
It is billed only for treatments
for pandemic cases during the pandemic. The plasma component should be
collected by apheresis method. Preparation, application processes and all
examination, materials and other operations are included. The regulations of
the Ministry of Health regarding the subject will be complied with. |
1.515,78 |
898,85754 |
The following
line has been added to come after the transaction line with the SUT code
“704941” in the list.
|
704942 |
Immune plasma supply and
administration |
It is billed only for treatments
for pandemic cases during the pandemic. The plasma component should be
collected by apheresis method. Preparation, application processes and all
examination, materials and other operations are included. The regulations of
the Ministry of Health regarding the subject will be complied with. |
1.515,78 |
|
|
ADULT-CHILDREN INTENSIVE CARE SERVICES |
|
|
|
|
|
P551990 |
Pandemic care service (for primary care intensive
care) |
Billed with P552001 only during the pandemic. Billed
once per day. |
|
* |
370,99 |
|
P551991 |
Pandemic care service (for secondary intensive care) |
Billed with P552002 only during the pandemic. Billed
once per day. |
|
* |
788,36 |
|
P551992 |
Pandemic care service (for tertiary intensive care) |
Billed with P552003 only during the pandemic. Billed
once per day. |
|
* |
1.485,00
|
|
P552001 |
primary care intensive care patient |
|
|
* |
426,64 |
|
P552002 |
Second-line intensive care patient |
|
|
* |
906,62 |
|
P552003 |
tertiary intensive care patient |
|
|
* |
1.707,75
|
• When the explanation sections are read, it is stated
that when a “pandemic” or “covid diagnosis” is added to the diagnosis of a
patient hospitalized in the intensive care unit for another reason, a second
intensive care treatment payment will be made to the intensive care treatment
over the “pandemic intensive care treatment code”. . Private and university
hospitals are rewarded with double the intensive care payments when they
arbitrarily add a diagnosis of "pandemic" to their diagnosis. This
means bribing hospitals to increase the covid intensive care and death rates.
As a result of this policy, all intensive care services seem to be full of
covid patients and the number of patients who died from covid has also
increased. This is a document of how the health system is a tool for covid
fraud.
• According to the research data of WHO based on 44
thousand patients, the people infected with the virus:
81% get off lightly
14% have serious
5% become seriously ill.
• 5% require intensive care treatment. However,
critically ill patients may require oxygen support, CPAP, BPAP, and mechanical
ventilation. it can hit.
https://www.bbc.com/turkce/haberler-dunya-51177538 ve
https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf (BBC removed access to this site.)
• When we analyze this information in terms of
SGK/SSI's health service purchasing and payment system, the following emerges:
SGK/SSI receives service from the hospitals it receives service from, according
to the declaration. SHS/HCP prepares
service documents according to the service it offers or wants to show, or the
money it wants to collect, and uploads it to the institution's MEDULA system in
monthly periods. The system supposedly examines 5% of this document amount,
according to the statement made by SHS/HCP
(according to the diagnosis and treatment scenario it has prepared). In
order to give the impression that a serious progress check is being made, a
so-called progress check is made on 5% of the documents and the declared amount
is paid to SHS/HCP.
What will private hospitals do in this case? With
constant TV broadcasts, everyone sees themselves as a Covid-19 patient and
thinks that they will need mechanical ventilation (respirator). Everyone wants
to take a test to find out whether they have the disease and pay whatever it
takes for it.• Private SHS/HCP will be
able to present anyone who has no suspicion of disease or clinic, who does not
require treatment and quarantine, as an intensive care treatment covid-19
patient who needs mechanical ventilation and immune plasma, and will be able to
issue a daily service document of 1490.35 TL for each of these people.
University professors who go to the cashier and don't look at you without
depositing 100-200 TL from this job will also earn serious money.
• Corona virus
infection has no VACCINE as of now; There is no effective or useful drug
therapy in the treatment of the virus. If there is a respiratory problem,
respiratory support can be provided with a mask or with mechanical ventilators
(mostly CPAP and BPAP devices that are not mechanical ventilators). This
practice has been extended as a lifeline to the SHS/HCP , whose number of
patients and earnings have decreased due to the stay-at-home policy. SGK/SSI
had previously paid for intensive care treatments. Most of the people whose
service documents were issued as intensive care units were not patients who
required intensive care. A pandemic care service code 510 021 has been added. A
statement has been made to those who will receive this service "regardless
of whether there is a pandemic or not". What does this mean: Private SHS/HCP will be able to call the patient who comes
before him as a corona pandemic patient or make it look like he has been
hospitalized and treated. Contrary to popular belief, the cost of treatment of
patients who really need mechanical ventilators is very low, as there are no
drugs and treatment methods.
• What does this mean: OSH, who has been given the
authority to designate the patient it wants as a covid-19 patient, will be able
to present many people who are not actually covid-19 patients as covid-19
patients. Therefore, the number of reported patients will be higher than those
who are actually sick. Since the payment made to these patients by the SSI has
been significantly increased, they will be able to make SHS/HCP s look like
patients who are hospitalized for other reasons and require intensive care, as
covid-19 patients. Since these service documents cannot be seen and examined by
anyone, it is not possible for people who do not know the system to examine and
see them. Private hospitals will never want the covid-19 epidemic to end.
It is clear that he does not know the health system
implemented in Turkey, the SGK/SSI health service purchasing and reimbursement
system, what kind of work private health insurance companies deal with and what
they pay. Likewise, those who wrote this article explain what privatization is
and what kind of system was introduced with the Transformation in Health; It is
understood that the health and insurance system does not know how to provide
services with a public approach (that is, a system in which it is not aimed to
make a profit from medical goods, products and services).
• The appointment of some SHS/HCP s as pandemic
hospitals by the Ministry of Health and the declaration of the Ministry of
Labor (SGK/SSI) that all transactions used in the treatment of coronavirus are
included in the scope of SGK/SSI reimbursement are also called publicism and
public practices in some press and TV. Making these comments by people who do
not know about the SGK/SSI health service purchasing and reimbursement system,
what their private SHS/HCP and health
insurances deal with and what they pay means that the SGK/SSI-based health
system is presented as a public service and at least the citizens are deceived.
CONCLUSIONS: Considering the
commitments made to the WTO and the loans received for this project implemented
and maintained by the World Bank and the agreements made with the bank, it will
be seen how difficult it is to create a nationalist system. Even after the
establishment of the Republic of Turkey, it had to pay capitulation debts. It cannot be expected that there is no
political movement or party in Turkey that opposes the current system, i.e.
Health Transformation, and that health workers and physicians, who are bought
by the system in accordance with the performance commissions (profit shares)
they receive, will also oppose it.
• Those who advocate 'publicity' in
the health and insurance system should especially understand what the Health
Transformation is. Health Transformation is a health market regulation and
privatization system implemented and maintained by the World Bank. With the
health service purchasing system implemented, all SHS/HCP s have turned into a
health shopping mall where the products of the medical cartel are freely
marketed and sold. This system, which was established for the free sale of
drugs, products and materials used in health care, also increased unnecessary
treatments and interventions as much as possible. This also means an increase
in iatrogenic complications and deaths due to faulty and unnecessary practices.
This system is not a local and national system for the benefit of the people.
5.4.2020
1.
2024 yılı Sosyal Güvenlik Kurumu Özel
Sağlık Hizmeti Sunucularından Sağlık Hizmeti Satın Alım Sözleşmesi
2024 Social Security institution Health Service Purchase Contract
From Private Health Service Providers (The form is the new version of the
contract and there is no change in the relevant articles.)
https://ozelhastaneler.org.tr/wp-content/uploads/2023/12/5de71c77-ed9a-4993-83fc-24deab5539dd.pdf
2.
SGK (Sosyal Güvenlik Kurumu) Sağlık
Uygulama Tebliği-
27/07/2022
SUT Değişiklik Tebliği İşlenmiş Güncel 2013 SUT (SGK
(Social Security Institution) Health Implementation Communiqué)
Open the
APPENDIX-2 LISTS file and look at the exell lists found there.
APPENDIX-2A-Per
Service Transaction Point List (Ap.01.06.2021)
APPENDIX-2B Diagnostic
Procedure Score (DRG) List (Ap.16.02.2022)
3.
News of www.haberturk.com / website: "Positive" pandemic payment to private
hospitals.
Özel hastanelere
"pozitif" pandemi ödemesi
06.09.2020
- 14:36 Güncelleme: 06.09.2020 - 14:38
Özel hastaneler, COVİD-19 ile mücadelede
yeniden devreye alındı. Sosyal Güvenlik Kurumu (SGK), özel hastanelerin, PCR
testi pozitif çıkan hastalara ilişkin tedavi hizmetlerini yeniden ödemeye
başlayacak. Geçmişe dönük de ödeme yapılacak. İşte yeni uygulamanın ayrıntıları
06.09.2020 - 14:36Update: 06.09.2020 - 14:38
Private hospitals were reactivated in the fight
against COVID-19. The Social Security Institution (SGK) will start paying
private hospitals again for treatment services for patients with positive PCR
tests. Retroactive payments will also be made. Here are the details of the new
application
Ahmet Kıvançakivanc@haberturk.com
Sosyal Güvenlik Kurumu (SGK), covid-19 pandemisinin hız kestiği haziran
ayından itibaren, özel hastanelerdeki Covid-19 tedavilerine yönelik ödeme
yapmayı durdurmuştu. Özel hastanelerde o tarihten sonra covid-19 tedavisi gören
hastalar için sadece standart hasta ödemeleri yapılmaya başlanmıştı.
Kamu hastanelerinde yoğunluğun artması üzerine özel hastaneler yeniden
devreye alındı. Haziran ayına kadar olan dönemde tüm covid-19 hastaları için
tedavi hizmetlerini karşılayan SGK, yeni mücadele döneminde sadece PCR testi
pozitif çıkan hastalara verilen hizmetleri karşılayacak.
Özel Hastaneler ve Sağlık Kuruluşları Derneği Başkanı Reşat Bahat, yeniden
artış eğilimine giren pandemiyle mücadelede özel hastanelerin devlete ait
sağlık kurumlarının yükünü artık paylaşabileceğini söyledi. Bahat, SGK’nın
sadece PCR testi pozitif çıkan hastalar için ödeme yapmasının eksiklik olduğuna
dikkat çekerek, hastaların sadece yüzde 60’ında PCR testinin pozitif çıktığını
belirtti. Hastaları pnomoni, kalp, solunum problemi olduğu zaman hastaneye
yatırdıklarını, PCR testi negatif çıksa bile bu belirtilerin hastaneye
yatırmayı gerektirdiğini kaydetti. Daha önce PCR testinin pozitif olması
zorunluluğu aranmadığını belirten Bahat, “Karar bütün covid-19 hastaları için
uygulamaya geçilse iyi olurdu. Yine de bu kararın alınmasında emeği geçen
herkese teşekkür ederiz” dedi.
SGK’nın şu anda başka hastalıklarla ilgili bir ödemesi olmadığını, çünkü
normal hastaların hastanelere gelmekten kaçındıklarını ifade eden Bahat, SGK
pandemi öncesindeki aylık ödemeyi yapmaya devam etse özel hastanelerin pandemi
ile mücadelede çok daha etkin bir şekilde kullanılabileceğini söyledi. Bahat,
şöyle devam etti:
“Özel hastanelere ödeme yapmaktan vazgeçtiklerinde eleştirmiştik, ‘pandemi
geçti de bizim mi haberimiz yok’ demiştik. ‘Sağlık Bakanlığına göre geçmedi,
SGK’ya göre geçti, hangisi doğru’ demiştik. Şimdi de alınan karar dolayısıyla
tüm yetkililere teşekkür ediyoruz. İnşallah devamı da gelir. Sağlık Bakanlığına
teşekkür ediyorum. Çok enerjik şekilde hastaları yeni açılan hastanelerde çok
da güzel tedavi etti. Üniversite ve özel hastaneler üzerindeki pandemi yükünü
azalttı. Bu arada biraz yabancı hastanın gelmesi, nefes almamızı sağladı. O
zaman hasta sayısı azalmıştı. Şimdi artışla beraber özel sektörün kuvvetli
şekilde devreye girmesi gerekecek gibi. Yoğun bakım servislerindeki doluluk
giderek yükseliyor.”
GERİYE DÖNÜK ÖDEME YAPILACAK
SGK, yeni kararı geçen hafta özel sağlık kuruluşlarına bildirdi. SGK, 1 Temmuz’dan
bu yana yapılan covid-19 tedavileri için de geriye dönük ödeme yapacak.
https://www.haberturk.com
/ozel-hastanelere-pozitif-pandemi-odemesi--2795179-ekonomi
4.
President Tayyip Erdoğan's statement on
Pandemic Payment (video)
https://disk.yandex.ru/i/XXvE2qTD5D90mA
https://sagligin-karanlik-yuzu.blogspot.com/search?q=HOW+WAS+THE+PATIENT+MADE+FOR+THE+FAKE+COVID+EPIDEMIC%3F+
Hiç yorum yok:
Yorum Gönder