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Εγγραφο με θεμα : "Καθορισμός της έκτασης εφαρμογής, του χρόνου και της διαδικασίας ηλεκτρονικής διαβίβασης δεδομένων στην Ανεξάρτητη Αρχή Δημοσίων Εσόδων, καθώς και κάθε άλλου αναγκαίου θέματος για την εφαρμογή των διατάξεων του άρθρου 15Α του ν.4174/2013 (Κ.Φ.Δ.) - Α.1138" μας απεστειλε η ΑΑΔΕ το οποιο προωθησαμε με email στα ενεργα μελη μας.

Αξιότιμο
Υφυπουργό Υγειας
Κύριο Βασίλη Κοντοζαμανη              Αρ. Πρωτ. 375
ΕΝΤΑΥΘΑ                                  Αθηνα, 23-6-2020

ΘΕΜΑ: Λειτουργία τακτικών χειρουργείων

Αξιότιμε κύριε Υπουργέ

Με το αρ. πρωτ. 516 22/5/2020 έγγραφο σας είχατε διευρύνει το ποσοστό διενέργειας τακτικών χειρουργείων από το 50% σε 75% σε σχέση με τα πραγματοποιηθέντα το 2019.

Επειδή η κανονικότητα έχει επιστρέψει στη ζωή μας, επειδή υπάρχει μια σημαντική αύξηση των τακτικών χειρουργείων ενόψει των καλοκαιρινών διακοπών αλλά και της ανασφάλειας των συμπολιτών μας για ενδεχόμενο νέο κύμα πανδημίας τον ερχόμενο Οκτώβριο, ζητάμε όπως απελευθερώστε το ποσοστό πραγματοποίησης τακτικών επεμβάσεων.

Στη διάθεση σας για οποιαδήποτε απορία ή διευκρίνηση.

Με την εκτίμηση μου
Για την Πανελλήνια Ένωση Ιδιωτικών Κλινικών

Γρηγόρης Σαραφιανός
Πρόεδρος ΔΣ

Subject: The EU’s recovery spending explained - by POLITICO

Dear UEHP members,

Please find here below an interesting analysis of the EU’s recovery spending made by POLITICO.

The EU’s recovery spending explained

-- By POLITICO
5/28/20, 6:30 AM CET |

There’s a total €1.85 trillion up for grabs under the European Commission’s new budget and recovery fund proposals.

Here’s POLITICO’s rundown of some of the main elements and the potential impact for key sectors of the EU’s economy.

INDUSTRY

Key figures: The Commission proposed two new funding streams to save beleaguered companies and invest in strategic value chains. It’ll allocate €5 billion from the current EU budget and €26 billion from the recovery fund for a Solvency Support Instrument aimed “at those companies that are in greatest need of capital across all member states and sectors.” That should ultimately generate up to €300 billion in private investment. The other instrument, dubbed the Strategic Investment Facility, is meant “to increase Europe’s resilience by building strategic autonomy in vital supply chains at the European level.” The Commission plans to put up €31.5 billion (which is supposed to trigger €150 billion in investments).

Potential impact: The solvency instrument would be primarily aimed at countries which don’t have the ability to distribute state aid, and those countries and sectors hardest hit by the crisis. It will be welcomed by poorer countries which risk seeing businesses go under, but is unlikely to stall the wave of bankruptcies if it isn’t agreed and deployed quickly.

How does this fit with the EU’s policy goals? The Strategic Investment Facility would invest in things like 5G, artificial intelligence, hydrogen and offshore wind. The investment guidelines for the Solvency Support Instrument “will also reflect the need to prioritise green investments,” the Commission wrote.

First reactions: Business representatives are keen to get the money fast. “From a business perspective, the question is as much about ‘how soon?’ as ‘how much?’… Our businesses cannot wait another six months for the roll out of much needed support,” said Christoph Leitl, president of Eurochambers, the association representing Europe’s chambers of commerce.

COHESION

Key figures: Cohesion programs would be allocated €323 billion from the EU budget over seven years — less than the €330 billion proposed in 2018 — but would get a top-up of €50 billion in recovery money from borrowed funding. The Commission is also asking for a boost of €5 billion for cohesion programs in the current EU budget, something that would entail countries injecting emergency cash into the bloc’s coffers over the coming months.

Potential impact: When it comes to the €50 billion, funding would go toward goals such as repairing labor markets, short time work schemes, support for health care systems, youth employment and helping small and medium-sized enterprises. The Commission is revising its rules to give countries extra flexibility on how to spend cohesion funding.

How does this fit with the EU’s policy goals? Green groups think not well. “By giving member states greater flexibility on how they will use EU regional development funds until as late as 2022, and by derailing programs from green objectives later, the EU runs the risk of more polluting activities being subsidized,” said Climate Action Network Europe’s Markus Trilling.

First reactions: The most contentious element of the proposal is how the new €50 billion would be allocated. Commission figures seen by POLITICO show the biggest beneficiary of the overall recovery funding is Italy, followed by Spain and Poland. France, one of the bloc’s wealthiest countries, would also qualify for significant sums. This approach is likely to be subject to intense negotiations. “Fair access to money for the real needs of member states is a key for the MFF compromise we all need,” Polish Minister for European Affairs Konrad Szymański said Wednesday.

AGRICULTURE

Key figures: European farmers would get €348 billion through the Common Agricultural Policy — an extra €24 billion from what the Commission envisaged in 2018. It adds a €20 billion top-up for rural development, which funds most of the greener farming projects in the bloc, of which €15 billion will come in borrowed money. There’s also a €4 billion add for direct payments to farmers.

Potential impact: Despite the boost, the plans would still see spending reduce by around €34 billion compared to the current budget cycle. That comes as agriculture sectors reel from the impact of the coronavirus crisis. A Commission analysis out Wednesday predicted EU agri-food companies could lose up to €37 billion in equity due to the pandemic.

How does this fit with the EU’s policy goals? The Commission presented the rural development boost as money to help farmers transition to more sustainable agriculture and meet the aims of the Green Deal. But whether the EU’s budget will really lead farmers toward greener pastures largely depends on the shape of the next CAP legislation, still in painstakingly slow discussions by EU institutions.

First reactions: The chair of the European Parliament’s agriculture committee Norbert Lins described the rural development boost as a “significant achievement” but added “we insist that the post-2020 budget for the EU farm policy must in no way be smaller than the current one.” Green groups including Greenpeace likened the move to increase rural development funding while maintaining vast subsidies to farmers to putting lipstick on a pig.

CLEAN MOBILITY

Key figures: The Commission said a massively expanded InvestEU package — beefed up to a total of €31.6 billion through borrowed money under the recovery fund — could go in part to drive investment in electric car charging facilities and greening urban transport. That would include using the Strategic Investment Facility to help funnel money into technologies that are “key” in the transition to clean energy, including batteries and hydrogen.

Impact: The Commission’s own estimates said the transport and automotive sectors could lose between €91 billion and €152 billion due to the crisis. In comparison, this is small change.

How does this fit with the EU’s policy goals? Transport has been caught in the Commission’s headlights, as it stressed in its communication that public money to reboot the EU’s transport sector should be matched by “a commitment from industry to invest in cleaner and more sustainable mobility.” But there are question marks over just how clean the transport investment plans are. “Spending big on shared and electric mobility is the right thing to do, but this plan leaves the door wide open for polluting engines and even airplanes to get stimulus money,” green lobby Transport & Environment’s William Todts said, warning of a “worrying lack of detail” on what would constitute green investment.

(Other) first reactions: With hydrogen on track to scoop up funding under the new Strategic Investment Facility, industry was happy. The fuels industry, too, called the proposal for the facility “encouraging.”

HEALTH

Key figures: The Commission proposed spending €9.4 billion on a new health program called EU4Health. The majority of that big figure — €7.7 billion — would come in borrowed funds from the recovery instrument, with €1.67 billion from the EU budget. Still, this is a huge change since 2018 when the Commission proposed allocating only €413 million from the EU budget to health. Plus, funds allocated to rescEU — part of the EU’s disaster protection mechanism and used to stockpile medical goods during the corona crisis — will increase to €3.1 billion.

Potential impact: The idea is that the funding from the recovery pot can be used to shore up national health systems to help with this crisis as well as any future virus outbreaks, with funding for laboratory capacity, as well as tools to monitor and forecast outbreaks. The Commission wants to build its ability to procure supplies such as ventilators and protective clothing and equipment, as well as a coronavirus vaccine if and when one is developed.

How does this fit with the EU’s policy goals? The new proposal would see the health program become independent — and the Commission stressed that’s because its ambitions in health go beyond solving the immediate crisis. The longer-term vision includes more efforts on prevention and improving access to diagnosis and treatment. It will also fund the creation of a European Health Data Space to encourage the exchange of health data to promote research.

First reactions: The health bubble is championing the standalone big health program as a major win. The European Public Health Alliance, for one, wrote that public health is “finally” getting “the recognition it deserves.” German MEP Tiemo Wölken is happy that the Commission’s proposal reflects proposals pushed by his S&D party. And unsurprisingly, Health Commissioner Stella Kyriakides is a fan of the plan, calling it “A game changer for our health.”

ROADS AND RAIL

Key figures: The Commission wants to spend €12.8 billion from the EU budget for the 2021-2027 period on transport infrastructure from the Connecting Europe Facility — an extra €1.5 billion on top of what it suggested back in May 2018. But a proposal for a military mobility program has been slashed to €1.5 billion from nearly €6 billion originally, after capitals ground the first proposal down during earlier negotiations.

Potential impact: The infrastructure funding would help cover the cost of some mega projects that need finishing, not least Rail Baltica, which the Commission’s plan named explicitly as a priority. That will go down well with the Baltics. But ultimately it’s a relatively small amount of money for meeting the bloc’s infrastructure goals.

How does this fit with the EU’s policy goals? The crisis shone a new light on the “crucial role” of transport as disruptions threw economies into disarray, the Commission said. The extra cash matches its new-found appreciation, but defense is no longer a priority, and that includes investment for roads and railways that can shift both troops and passengers around Europe.

First reactions: Greens MEP Karima Delli, who heads the Parliament’s Transport and Tourism Committee, said the Commission “hasn’t been ambitious at all when it comes to transport,” despite its “key role” in the crisis.

DIGITAL

Key figures: The Digital Europe program is to get €8.2 billion over seven years, an increase of €1.5 billion from the Council’s February draft and the full amount initially proposed by the Commission in 2018. Proposed investment in digital infrastructure through the Connecting Europe Facility comes to €1.8 billion.

Potential impact: The money will be used to develop electronic identities that work across the bloc and build “strategic digital capacities and capabilities,” including artificial intelligence, cybersecurity, secured communication, data and cloud infrastructure, 5G and 6G networks, supercomputers, quantum and blockchain.

How does this fit with the EU’s policy goals? The Commission has resisted pressure from EU countries to cut digital funds as it looks to boost Europe’s industrial and technological prowess. But it’s not clear if the funds will be enough to meet the bloc’s aims — with, for instance, an ambitious Data Act. That would create a European single market for data and encourage the Continent’s industrial heavyweights to share data and feed artificial intelligence applications; data sharing has moved into the limelight with the coronavirus, as senior officials tout it as another way the bloc can fight the pandemic.

First reactions: Leading tech lobby Digital Europe was not impressed. “Digital technologies are the backbone of a resilient society. It is therefore puzzling that the dedicated funds for digital – the Connecting Europe Facility and the Digital Europe Programme – have not been given any extra funding,” said Director General Cecilia Bonefeld-Dahl.

CLIMATE

Key figures: The Commission backed increased spending on the Just Transition Fund, Brussels’ signature scheme for helping to clean up industry, from an original €7.5 billion planned to a total €40 billion. That would include €30 billion of borrowed money. Overall the Commission wants 25 percent of budget spending to go toward meeting climate goals (a target it hasn’t increased since its 2018 proposal).

Potential impact: Brussels’ plan might force industry to speed up their greening efforts. Under the proposals, public coronavirus recovery investments should “do no harm” and follow the bloc’s energy and climate priorities (although that’s not binding). Countries would have to design national recovery plans to access €560 billion of the recovery fund in line with their national climate plans. Brussels also wants the new taxonomy criteria — an EU framework now being finalized for what constitutes sustainable investments — to “guide investments.”

How does this fit with the EU’s policy goals? The Commission’s Green Deal project calls for the bloc to become climate neutral by 2050. There had been fears that the pandemic response would gut that goal as countries raced to prop up their economies. But the Commission has insisted it won’t abandon the longer-term climate goal, and a range of initiatives from the just transition to hydrogen and battery initiatives show that the recovery and the budget do have something of a green tint.

First reactions: Campaigners said there aren’t enough controls to ensure recovery investments go toward hitting the bloc’s climate goals or explicitly excluding investments in fossil fuels. WWF said the plans don’t ensure countries won’t invest in “harmful activities such as fossil fuels or building new airports and motorways.” Friends of the Earth Director Jagoda Munic said “too many of the measures fall short of the goals of the European Green Deal.”

RESEARCH AND INNOVATION

Key figures: The Horizon Europe research fund would get a total €94.4 billion under the proposal, including €13.5 billion in borrowed money from the EU recovery fund. The amount allocated directly from the EU budget was reduced from the Commission’s 2018 proposal.

Potential impact: The Commission says the additional money through the recovery fund will help make progress tackling coronavirus — whether that be through vaccine research or improving the science that governments are using daily to make decisions on how to manage the crisis.

How does this fit with the EU’s policy goals? The move shows the Commission’s plans to commit in particular to more research on health — but the decision to reduce the amount of proposed funding from the EU budget in favor of shorter-term recovery funds (which may also be spent on different things) raises questions over its longer-term commitment to research and innovation as a policy objective.

First reactions: German conservative MEP Christian Ehler said the figures were hugely problematic for the bloc’s ambitions for an economic recovery and tackling climate change: “Not having a significant increase of the European research budget is not just disappointing, it is almost suicidal.” Cecile Vernant, head of development NGO Deutsche Stiftung Weltbevoelkerung (DSW)’s EU office said she was “delighted” to see the EU commit more to health research.

ENVIRONMENT

Key figures: Under the budget proposal, the LIFE fund for environment and climate would increase from €3.2 billion in the current budget cycle to €4.8 billion. Plus, there’s money for environmental aims among the €196 billion allocated to the European Regional Development Fund (part of cohesion funding) and the €90 billion of agriculture money for rural development.

Potential impact: In addition to money spent on environmental protection in the budget, von der Leyen said that the money spent on recovery “should be consistent with the Union’s climate and environmental objectives,” without detailing much how this would work in practice. Green MEP Bas Eickhout also warned during a debate in plenary that this principle seems to apply only to public investments in the recovery,  and not the €1.1 trillion of the EU budget, thus leaving the door open to EU financing of polluting sectors.

How does this fit with the EU’s policy goals? The Commission proposed an ambitious strategy on May 20 to stop biodiversity loss, with the objective of placing 30 percent of the EU’s land and seas under a protected status and slashing the use of chemical pesticides by 50 percent by 2030. However, to reach those high ambitions the bloc must overcome an investment gap of an estimated €68 billion per year — a target unlikely to be reached by the allocated money.

First reactions: Environmental groups welcomed the overall proposal but pointed out that direct investments into nature protection and pollution prevention were still missing. “The Commission’s proposals fail to address the enormous problem of toxic pollution, which is a major threat to our health,” said Jeremy Watson, secretary-general of the European Environmental Bureau, an NGO. The European Parliament will also not be pleased: Previously MEPs demanded at least 10 percent of the budget (similar to the number proposed by environmental groups) be earmarked for biodiversity conservation.

Eddy Wax, Paola Tamma, Lili Bayer, Jillian Deutsch, Carlo Martuscelli, Joshua Posaner, Hanne Cokelaere, Vincent Manancourt, Melissa Heikkilä, America Hernandez, Aitor Hernández-Morales, Kalina Oroschakoff, Eline Schaart, Louise Guillot and Laura Greenhalgh contributed to this article.

Dear UEHP members,

today the European Commission presented its Recovery plan for Europe, to help repair the economic and social damage brought by the coronavirus pandemic, to kick-start European recovery, and to protect and create jobs.

The Commission is proposing a major recovery plan based on harnessing the full potential of the EU budget,putting forward a two-fold response:

 1) Next Generation EU: a new recovery instrument of €750 billion which will boost the EU budget with new financing raised on the financial markets for 2021-2024

 2 A reinforced long-term budget of the EU for 2021-2027:The Commission remains fully committed to delivering on its flagship initiatives, the Green Deal, the digital transition, a fair and inclusive recovery, a more resilient Europe which are key to relaunching the European economy.

 

WHAT's IN IT FOR HEALTH?

The European Commission's proposed a standalone health program, EU4Health, which will have a budget of €9.4 billion, according to a Commission document.

Up until now, the EU's health budget has been part of the European Social Fund.

The Commission laid out a number of health-related aspects in its Multiannual Financial Framework and Recovery Instrument proposals, including investing more in health systems; improving coordination between countries; and fighting medicine shortages.

Here’s what we know so far:

— Health systems: The Commission will invest more in health systems and create a long-term vision for “for well-performing and resilient public health systems.”

— rescEU: Part of the EU's disaster protection mechanism, rescEU will get more cash for its emergency response infrastructure, transport capacity and emergency support teams, while creating an EU reserve of essential medical supplies and equipment to be used in emergencies.

— Drug shortages: The Commission document stressed the importance of creating a secure supply of active pharmaceutical ingredients. The proposed solution is a new “Strategic Investment Facility,” which will "support cross-border investments to help strengthen and build European strategic value chains." More details will be spelled out in the Commission’s new pharmaceutical strategy to be published in the fourth quarter.

— EU agencies: The European Medicines Agency should get beefed-up authority to monitor drug shortages, while the European Centre for Disease Prevention and Control should have more power in "coordinating surveillance, preparedness and response to health crises.”

— Health data: The new plan would create a European Health Data Space to encourage the exchange of health data to aid research. This idea was included in earlier Commission plans.

— Research: The Commission will reinforce Horizon Europe to support health research, which "will be essential" in the development of vaccines and treatments, while making the EU more independent in supply chains.

— Procurement: The Commission wants to strengthen the "EU's health regulatory framework" and its ability to procure items, including a vaccine "in the immediate term."

— Global cooperation: The Commission is proposing supporting “global partners” by strengthening the Neighborhood, Development and International Cooperation Instrument and the Humanitarian Aid Instrument. The Commission also reaffirmed its commitment to working with international organizations like the World Health Organization and G7, and to making any vaccine against the coronavirus available and affordable for the world.

More information at: https://ec.europa.eu/info/live-work-travel-eu/health/coronavirus-response/recovery-plan-europe_en

Best regards,

ΕΛΛΗΝΙΚΗ ΔΗΜΟΚΡΑΤΙΑ

ΥΠΟΥΡΓΕΙΟ ΥΓΕΙΑΣ

ΓΡΑΦΕΙΟ ΥΦΥΠΟΥΡΓΟΥ ΥΓΕΙΑΣ

Με εγγραφο του Υφυπουργου Υγειας κου Κοντοζαμανη αυξανεται απο 25-5-2020 το ποσοστο των μηνιαιων χειρουργειων σε 75% σε μηνιαια βαση σε σχεση με το μεσο μηνιαιο οριο του 2019

Παρακολουθειστε ολη τη συζητηση 
https://www.facebook.com/HealthDailyGr/videos/238808874041921/

Health Daily 19-5-2020

Γ. ΣΑΡΑΦΙΑΝΟΣ: ΠΙΘΑΝΑ «ΛΟΥΚΕΤΑ» ΣΕ ΙΔΙΩΤΙΚΕΣ ΚΛΙΝΙΚΕΣ

Πτώση εσόδων κατά 70%

Πολύ πιθανό είναι να δούμε λουκέτα σε ιδιωτικές κλινικές τον Σεπτέμβριο, καθώς η πτώση των εσόδων στον κλάδο ανέρχεται σε 70% και υπάρχει έλλειψη ρευστότητας, επεσήμανε ο Γρηγόρης Σαραφιανός, πρόεδρος της Πανελλήνιας Ένωσης Ιδιωτικών Κλινικών (ΠΕΙΚ), μιλώντας στην αρχισυντάκτρια του Health Daily και στο #Communitytalks. Ανέφερε ότι οι πληρότητες στον ιδιωτικό τομέα όσον αφορά τα τακτικά χειρουργεία κυμαίνονται σε πολύ χαμηλά ποσοστά. Ειδικά ο Μάιος και Ιούνιος, παραδοσιακά πολύ καλοί μήνες για τις ιδιωτικές κλινικές, φέτος βρίσκονται πολύ χαμηλά αναφορικά με τις πληρότητες. Για τον λόγο αυτό οι ιδιωτικές κλινικές εντάχθηκαν στις πληττόμενες επιχειρήσεις. Όμως, παρότι πληττόμενες, οι ιδιωτικές κλινικές έπρεπε να διατηρήσουν όλο το προσωπικό και τις κλίνες τους σε πλήρη ετοιμότητα, λόγω κορονοϊού, δεν μπορούσαν να εφαρμόσουν αναστολές συμβάσεων η ευέλικτες μορφές εργασίας, με αποτέλεσμα να αυξήσουν τα λειτουργικά τους έξοδα κατά 10-15 ευρώ ανά κλίνη νοσηλείας. Επίσης, ανέφερε ότι 2.000 νοσηλευτές που προσλήφθηκαν από το υπουργείο Υγείας προήλθαν κατά κύριο λόγο από τον ιδιωτικό τομέα, ο οποίος κυριολεκτικά απογυμνώθηκε. Ως λύση προτείνεται η μείωση του ΦΠΑ στις υπηρεσίες των ιδιωτικών κλινικών, από το 24% στο 6% (κάτι που ισχύει για τα φάρμακα) ή έστω στο 13%, ως ένας έμμεσος τρόπος μείωσης του clawback, χωρίς να χρειάζεται αλλαγή του νόμου.

Αναφορικά με τα τεστ για Covid-19  που πρέπει να γίνονται σε ασθενείς που έχουν προγραμματίσει τακτικά χειρουργεία ή χημειοθεραπείες σε ιδιωτικές κλινικές, ο κ. Σαραφιανός αναφέρθηκε στην εγκύκλιο του ΓΓ του υπουργείου Υγείας που εκδόθηκε στις 11 Μαΐου, η οποία αναφέρει ότι τέτοια τεστ γίνονται μόνο σε ασθενείς που χρειάζονται ολική νάρκωση, καθώς και σε ασθενείς που για πρώτη φορά κάνουν χημειοθεραπεία. Άλλα χειρουργεία, καθώς και εγχύσεις φαρμάκων για ρευματοπαθείς, δεν χρειάζονται τεστ για covid-19. Για να μην επιβαρύνεται ο ασθενής πρέπει 48 ώρες πριν να κάνει το τεστ σε δημόσια νοσοκομεία. Ωστόσο, ανέφερε ότι θα έπρεπε και τα υπόλοιπα χειρουργεία κατά τη γνώμη του να γίνονται μόνο μετά από το τεστ. Τα rapid test έχουν αξιοπιστία 90%

Ερωτηθείς για τις ακτινοθεραπείες στον ιδιωτικό τομέα και την αποζημίωσή τους από τον ΕΟΠΥΥ, ο κ. Σαραφιανός δήλωσε ότι είναι θέμα ερμηνειών. Σύμφωνα με την συμφωνία που έχει γίνει με τον ΕΟΠΥΥ από το 2011, οι αμοιβές των γιατρών εξαιρούνται από την κάλυψη, εκτός εάν πρόκειται για μονάδες εντατικής θεραπείας. Το ίδιο ισχύει και στα Κλειστά Ενοποιημένα Νοσήλια (ΚΕΝ).

Αναφορικά με το claw back, ο κ. Σαραφιανός ανέφερε ότι δεν υπάρχει διάλογος με το υπουργείο, καθώς μέχρι το 2022 ισχύει το ίδιο καθεστώς, που προκύπτει από τον γνωστό μνημονιακό νόμο. Ωστόσο, ανέφερε, ότι παρά το γεγονός ότι ένας κλειστός προϋπολογισμός συμφέρει το υπουργείο, το δίκαιο και ηθικό θα ήταν όταν τελειώνουν τα προβλεπόμενα στον προϋπολογισμό κονδύλια, να σταματά και η σύμβαση με τον ΕΟΠΥΥ μέχρι τις αρχές του νέου έτους, που θα υπάρχει ο νέος προϋπολογισμός και τα αντίστοιχα κονδύλια.