Referans "Eczacı"

Ömür Çakmak Cu, 30/08/2019 - 11:43

Tüm Eczacı İşverenler
Sendikasının yaptığı ankete göre eczane sahibi eczacıların yüzde 73’ü hâlinden
hiç memnun değil. Hatta bunun yüzde 23’ü iş değişikliği yapmayı düşünüyor.
Sebebini az çok biliyorsunuzdur, kısaca değinelim.



Türkiye'de eczane işleten eczacılar son yıllarda "Sağlık harcamalarının kısıtlanması" politikalarından en olumsuz yönde etkilenen
meslek gruplarından biri hâline geldi. Sağlıkta bütçe açığından kaynaklı
olarak, diğer dikkat çeken harcamalar göz ardı edilip fatura en başta ilaç
harcamalarına kesildi. "Referans Fiyat Uygulaması" kapsamında bir
ilacın dünyadaki eşdeğerlerinden en ucuzunun fiyatı referans alınarak ilaç
fiyatları düşürüldü. Aslında bu temelde haklı ve doğru bir işti. Ancak bu süreç
doğru yönetilemediği için eczacıları madur etti. Eczacılar fiyat düşüşleri
oranında çok ciddi stok zararıyla karşı karşıya kaldılar. Maliyet ve girdileri
sürekli artmasına rağmen stok zararlarıyla birlikte, ciroların -doğal olarak-
nerdeyse %100'e varan oranlarda düşmesi eczacıları zor durumda bıraktı.
 Bu süreçte neredeyse dört-beş kat fiyatı ucuzlayan ilaçlar olduğunu
gördük. Zamanında ilaç sektörünün Türkiye'mizden büyük paralar götürmüş olduğunu
da böylelikle öğrendik. Fiyatlar düşürülsün, bir ilacın hakiki değeri ne ise
bedeli o şekilde ödensin eczacının buna itiraz ettiği yok. Nitekim her dönem
"Referanstan İlaç Fiyatı Düşüşleri" devam ediyor. Ancak bunlar yapılırken  vatandaş açısından
durum nedir, Türkiye'de sayısı 26 bini aşkın eczane ve orda çalışanlar
 açısından durum nedir, maduriyetler nasıl giderilebilir diye
bakılmalıdır.



İlaç fiyatları düşüyor da vatandaşın cebinden çıkan para düşüyor mu? Sigorta
primini ödemiş veya ödemekte olanlar dahil olmak üzere, her muayeneden ve
reçete edilen ilaç kutusu başına SGK vatandaştan "muayene ve reçete bedeli" adı altında para kesiyor. Eğer ki vatandaş
emekli statüsündeyse bu ücretler vatandaşın maaşından kesiliyor, eğer emekli
değilse Sosyal Güvenlik Kurumu adına vezneliği eczaneler yapıyor. Eczacılar
vatandaşla karşı karşıya kalıyor, bu ücretlerin devlete kesildiği anlatmakta
büyük sıkıntılar yaşanıyor.  Öte yandan birçok ilaç, fiyatını eşdeğer
referans ilaç fiyatına tam olarak çekmediği için, kurumun ödememesinden
kaynaklı çıkan fiyat farklarını da hastadan tahsil etmek yine eczacıya düşüyor.
Sosyal Güvenlik Kurumu tarafından bedeli hiç ödenmeyen ilaçlar ise cabası..
Neticede ilaç harcaması için vatandaşın cebinden çıkan para azalmadı bilâkis
arttı. Eczanelerin durumu ise gün geçtikçe daha da kötüleşiyor. Ciroların ciddi
oranda azalmasıyla düşen kârlılığın üstüne her dönem doğan yeni stok zararları
eklenince, üstüne üstük bir de gider kalemleri artınca eczaneler hızla kan
kaybediyor. Madem ki Avrupa'daki 5 ülkedeki ilaç fiyatları referans alınarak
fiyatlar düşecek, düşsün lâkin oralardaki eczanelerin durumu da referans
alınsın.



Avrupa ülkelerinde ve Dünyanın diğer ülkelerinin çoğunda; halk sağlığına
dönük kamu hizmeti ve danışmanlık yaptıkları için eczacılara "meslek
hakkı" ödenmektedir. Örneğin; Hollanda'da reçete başına 6.10 euro,
Fransa'da ilaç kutusu başına 0,53 euro sisteme girme bedeli olarak 0.10 euro,
Almanya'da reçete başına 8.3 euro, Avusturya reçete başına 4.8 euro, İngiltere
reçetelenen ürün başına 90 peni ambalaj ödeneği olarak 3,24 peni, ABD'de reçete
başına 9 dolar meslek hakkı ödenmektedir. Referans göstererek fiyat düşürülen
ülkelerde eczanelerin yaşatılması ve itibarını koruyabilmesi için referans
uygulama genellikle budur. Ne var ki Türkiye'mizde eczacıların meslek hakkı
talebine henüz olumlu yanıt verilmemiştir. Bahane olarak SGK, ilaç bedeli
ödemelerinin %40'ının sadece 1000 küsür eczaneye yapılmakta olduğunu, eğer
meslek hakkı ödenirse bu tutarları ödemenin bütçeyi zorlayacağı gibi bu uygulamanın
eczacıların çoğunluğuna değil zengin küçük bir azınlığına (%4'üne) yarayacağını
öne sürmektedirler. Halbuki bu durumu eczacıların çoğunluğunun leyhine çevirmek
öyle zor bir iş değildir. Meslek hakkı uygulamasında ortalama bir üst sınır
koymak veya reçete sayısına göre meslek hakkı belirlemek suretiyle ortaya
çıkacak dengesizlik giderilebilir. Öte yandan devletin özel sektöre çok
görmediği harcamaları; halk yararına kamu sağlığı hizmeti ile birlikte,
devletin tahsildarlığını bile yapmakta olan eczacıya çok görmek açık bir çifte
standarttır. Geçmişte uygulanan yanlış bütçe politikalarının sorumlusu
eczacılar ve diğer vatandaşlar değildir, o yüzden o sorumluluğun bedeli de,
sağlık giderlerinin faturası da eczacılara veya vatandaşlara ödetilmemelidir.



Eczacılar bu ülkenin tahsil görmüş, sağlık hizmeti veren öz evlatlarıdır.
Mevzubahis "referans" ise hakkaniyet ilkelerine uyulması gerekir.
Kamu leyhine olan "referansları" görüp, eczacı ve vatandaş leyhine
olanları görmezden gelmek adil bir yaklaşım olarak değerlendirilemez.



Ecz. ÖMÜR ÇAKMAK

Yorumlar

MichaelTrose (doğrulanmamış) Per, 08/05/2025 - 20:15

Possibilities
The authors of the study, published May 6 in the journal Monthly Notices of the Royal Astronomical Society, specifically set out to search for Dyson spheres, in the form of infrared heat near stars that couldn’t be explained in any other way.
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Using historical data from telescopes that pick up infrared signatures, the research team looked at stars located within less than 1,000 light-years from Earth: “We started with a sample of 5 million stars, and we applied filters to try to get rid of as much data contamination as possible,” said lead study author Matias Suazo, a doctoral student in the department of physics and astronomy of Uppsala University in Sweden.

“So far, we have seven sources that we know are glowing in the infrared but we don’t know why, so they stand out.”
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There is no conclusive evidence that the seven stars have Dyson spheres around them, Suazo cautioned.

“It’s difficult for us to find an explanation for these sources, because we don’t have enough data to prove what is the real cause of the infrared glow,” he said. “They could be Dyson spheres, because they behave like our models predict, but they could be something else as well.”

Among the natural causes that could explain the infrared glow are an unlucky alignment in the observation, with a galaxy in the background overlapping with the star, planetary collisions creating debris, or the fact that the stars may be young and therefore still surrounded by disks of hot debris from which planets would later form.
The data used by the researchers comes from two active space telescopes — the Wide-field Infrared Survey Explorer, or WISE, from NASA and Gaia from the European Space Agency — as well as an astronomical survey of the sky in infrared light called The Two Micron All Sky Survey. Also known as 2MASS, the collaboration between the University of Massachusetts and the US space agency’s Jet Propulsion Laboratory took place between 1997 and 2001.

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Possibilities
The authors of the study, published May 6 in the journal Monthly Notices of the Royal Astronomical Society, specifically set out to search for Dyson spheres, in the form of infrared heat near stars that couldn’t be explained in any other way.
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Using historical data from telescopes that pick up infrared signatures, the research team looked at stars located within less than 1,000 light-years from Earth: “We started with a sample of 5 million stars, and we applied filters to try to get rid of as much data contamination as possible,” said lead study author Matias Suazo, a doctoral student in the department of physics and astronomy of Uppsala University in Sweden.

“So far, we have seven sources that we know are glowing in the infrared but we don’t know why, so they stand out.”
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There is no conclusive evidence that the seven stars have Dyson spheres around them, Suazo cautioned.

“It’s difficult for us to find an explanation for these sources, because we don’t have enough data to prove what is the real cause of the infrared glow,” he said. “They could be Dyson spheres, because they behave like our models predict, but they could be something else as well.”

Among the natural causes that could explain the infrared glow are an unlucky alignment in the observation, with a galaxy in the background overlapping with the star, planetary collisions creating debris, or the fact that the stars may be young and therefore still surrounded by disks of hot debris from which planets would later form.
The data used by the researchers comes from two active space telescopes — the Wide-field Infrared Survey Explorer, or WISE, from NASA and Gaia from the European Space Agency — as well as an astronomical survey of the sky in infrared light called The Two Micron All Sky Survey. Also known as 2MASS, the collaboration between the University of Massachusetts and the US space agency’s Jet Propulsion Laboratory took place between 1997 and 2001.

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The authors of the study, published May 6 in the journal Monthly Notices of the Royal Astronomical Society, specifically set out to search for Dyson spheres, in the form of infrared heat near stars that couldn’t be explained in any other way.
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Using historical data from telescopes that pick up infrared signatures, the research team looked at stars located within less than 1,000 light-years from Earth: “We started with a sample of 5 million stars, and we applied filters to try to get rid of as much data contamination as possible,” said lead study author Matias Suazo, a doctoral student in the department of physics and astronomy of Uppsala University in Sweden.

“So far, we have seven sources that we know are glowing in the infrared but we don’t know why, so they stand out.”
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There is no conclusive evidence that the seven stars have Dyson spheres around them, Suazo cautioned.

“It’s difficult for us to find an explanation for these sources, because we don’t have enough data to prove what is the real cause of the infrared glow,” he said. “They could be Dyson spheres, because they behave like our models predict, but they could be something else as well.”

Among the natural causes that could explain the infrared glow are an unlucky alignment in the observation, with a galaxy in the background overlapping with the star, planetary collisions creating debris, or the fact that the stars may be young and therefore still surrounded by disks of hot debris from which planets would later form.
The data used by the researchers comes from two active space telescopes — the Wide-field Infrared Survey Explorer, or WISE, from NASA and Gaia from the European Space Agency — as well as an astronomical survey of the sky in infrared light called The Two Micron All Sky Survey. Also known as 2MASS, the collaboration between the University of Massachusetts and the US space agency’s Jet Propulsion Laboratory took place between 1997 and 2001.

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