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
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While manufacturers continue…
In reply to подробнее https://forum.hpc… by Pedrocyday (doğrulanmamış)
While manufacturers continue to tweak their products to overcome the stigma of ultraprocessed foods, nutritionists suggest consumers move forward in choosing products that help the planet — as long as they keep reading the nutrition label.
“I would look for something with a good fat composition in which saturated fat is less than a third of the total fat,” Willett said. “Some vegetable burgers made from peas and legumes can be quite starchy, which the body breaks down similarly to sugar, so I would prefer to see alternatives with more healthy fat, more nuts, more soy.”
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While the Dietary Guidelines for Americans call for a limit of 2,300 milligrams of sodium per day for adults, “the American Heart Association recommends a limit of 1,500 milligrams for adults over 50, which is the standard I prefer,” Willett said.
“Look for about 1 milligram of sodium per calorie, which is a pretty good criteria,” he added. “In general, salt and saturated fat are the two really important factors — along with something that’s flavorful or delicious, which is, of course, up to the consumer.”
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One more key point from Willett: Before plant-based meats can truly help save the planet, they need to come down in price.
“These products are quite a bit more expensive, from what I’ve seen, than basic hamburger,” he said, “and we really need products that are price competitive with the beef and pork if we’re going to see them used on a daily basis, not just by people who can afford it.”
When Hussain AlMoosawi…
In reply to подробнее https://forum.hpc… by Pedrocyday (doğrulanmamış)
When Hussain AlMoosawi arrived home, he didn’t recognize anything.
The Emirati photographer, who had spent eight years studying in Australia, returned to the United Arab Emirates (UAE) in 2013. He’d missed a real estate boom of dizzying proportions: not just new buildings, but new districts.
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More than that, the buildings of his childhood were disappearing, replaced by shiny new skyscrapers.
But for AlMoosawi, these international icons were not the urban fabric of his home: it was the oft-overlooked, mid-century office towers and residential blocks squeezed between new highways and overshadowed by luxury developments that felt most familiar.
It sparked a desire to “understand the urban context of the UAE,” and AlMoosawi set out to meticulously document and capture these underappreciated buildings, “and reimagine the city as if it were the ‘80s, the time when I was born.”
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Initially focusing on industrial landscapes, temporary structures and air conditioning units, he began to notice symmetry in many of the buildings he was photographing, inspiring his current project: facades.
“Facades are like a face,” said AlMoosawi. “It’s something that people connect with.”
His bold, geometric images strip away context to spotlight the character and diversity of everyday buildings. Using a telephoto lens to shoot close-ups from the ground or elevated positions, AlMoosawi carefully frames out distractions and sometimes removes minor obstructions like lampposts in post-processing.
So far, the 41-year-old, who is editor-in-chief for National Geographic AlArabiya Magazine, has photographed over 600 building?s across the UAE, and next year hopes to complete his collection in Abu Dhabi, where he lives.
In the long term, he hopes to turn the “lifetime project” into an interactive archive that both preserves urban heritage and invites viewers to rediscover their own city.
“Our cities aren’t big, in terms of scale, compared to many other cities,” said AlMoosawi. “But then they have a story to tell, they have things between the lines that we don’t see, and my quest is to see these things.”
Since India’s independence…
In reply to подробнее https://forum.hpc… by Pedrocyday (doğrulanmamış)
Since India’s independence from Britain in 1947, the status of English in India has been deeply political – entwined with questions of identity, power, and national direction.
Today, English is one of several official languages in India, spoken by about 10% of the population. Hindi is the first language for around 44% of citizens, according to the 2011 census.
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But in recent years, Modi’s BJP has placed particular emphasis on promoting Hindi and reducing the use of English in public life.
The prime minister almost never delivers speeches in English, preferring Hindi for national addresses such as his monthly radio program. His administration has encouraged officials to use Hindi on social media and in government correspondence – though, after criticism from non-Hindi-speaking states, clarified that this was intended mainly for the Hindi belt in the north.
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When India hosted world leaders for the 2023 G20 summit in New Delhi, invitations were sent out from “Bharat” – the Sanskrit or Hindi name for the country – instead of “India,” fueling speculation that the government aims to ultimately phase out the country’s English designation altogether.
Modi’s critics have been quick to note his political motives behind these moves.
With its roots in the Rashtriya Swayamsevak Sangh (RSS), a right-wing organization that advocates Hindu hegemony within India, the BJP’s language policies resonate with many in a country where nearly 80% of people are Hindu.
Analysts say the BJP is seeking to capitalize on this demographic by promoting language policies that strengthen its support base in the north.
According to Rita Kothari, an English professor from Ashoka University, the government “is certainly interested in homogenizing the country and making Hindi more widespread.”
But that policy can also backfire – in part because many regions, such as Marathi-speaking Maharashtra in the west – are staunchly proud of their local language.
The violent clashes in the state’s megacity Mumbai earlier this month were sparked by the regional government’s controversial decision to make Hindi a compulsory third language in public primary schools.
Pushback and protest has also been especially strong in the south, where English and regional languages such as Tamil, Telugu, and Kannada are valued as symbols of local identity and autonomy.
Stunning images show Arctic…
In reply to подробнее https://forum.hpc… by Pedrocyday (doğrulanmamış)
Stunning images show Arctic glaciers’ dramatic retreat
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Swedish photographer Christian Aslund is riding a small boat along the coast of Spitsbergen, an island in the Norwegian archipelago of Svalbard. Here, deep into the Arctic Circle and midway between Norway and the north pole, he is investigating the health of the glaciers, by comparing them to what they looked like in archival photos.
He takes a picture, trying to place his boat in the exact position occupied by an explorer who took a similar photograph over 100 years ago. But the difference is striking: in the shot from 1918, the boat is heading towards a massive glacier. In the image Aslund took in 2024, he is heading toward what looks like almost bare land.
The comparison is part of a series that Aslund worked on in collaboration with the Norwegian Polar Institute and Greenpeace, to document the retreat of Svalbard’s glaciers over the last century. He visited the area twice — in 2002 and in 2024 — and picked which sites to photograph based on historical images that he found in the institute’s archives.
“In 2002, the widespread knowledge, or acceptance, of climate change wasn’t as broad as it is now,” Aslund says. He published the first set of photos over 20 years ago to create awareness of how much the glaciers were receding. But to his surprise, he received some comments suggesting that the images had been “Photoshopped,” that the glaciers were just expanding and contracting naturally, or that he had taken the pictures in the summer and compared them to archival shots taken in the winter: “But they are not — if you look at at the archive photos, you see that they don’t have any sea ice and not enough snow on the mountains (for it to be winter). And also, in the winter, it’s permanently dark.”
In the summer of 2024, he decided to return, taking pictures at the exact same locations as before. “I had a feeling that the glaciers would have receded even more,” he says, “and that was confirmed. We wanted to show that these glaciers are not going back and forth. They are constantly being pulled back by a warming climate. It’s a major difference.”
The Arctic has been warming twice as fast as the rest of the world since the year 2000, according to the National Oceanic and Atmospheric Administration, but according to other estimates it has warmed even more — four times faster than the global average since 1979. NASA says summer Arctic sea ice is shrinking by 12.2% per decade due to warming temperatures.
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Tbilisi, Georgia — Jailed…
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Tbilisi, Georgia — Jailed journalist Mzia Amaghlobeli gets weaker every day as her hunger strike has reached three weeks in Rustavi, a town near the Georgian capital of Tbilisi, her lawyer says. Now the 49-year-old is having difficulty walking the short distance from her cell to the room where they usually meet, and human rights officials, colleagues and family fear for her life.
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Amaghlobeli was arrested Jan. 12 during an anti-government protest in the coastal city of Batumi, one of over 40 people in custody on criminal charges from a series of demonstrations that have hit the South Caucasus nation of 3.7 million in recent months.
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The political turmoil follows a parliamentary election that was won by the ruling Georgian Dream party, although its opponents allege the vote was rigged.
Protests highlight battle over Georgia's future. Here's why it matters.
Its outcome pushed Georgia further into Russia's orbit of influence. Georgia aspired to join the European Union, but the party suspended accession talks with the bloc after the election.
As it sought to cement its grip on power, Georgian Dream has cracked down on freedom of assembly and expression in what the opposition says is similar to President Vladimir Putin's actions in neighboring Russia, its former imperial ruler.
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‘Hire back park staff’:…
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‘Hire back park staff’: Visitors feel the pinch of Trump’s layoffs at National Park Service
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The visitors who trek to America’s national parks are already noticing the changes, just months after President Donald Trump took office.
“I’ve been visiting national parks for 30 years and never has the presence of rangers been so absent,” one visitor to Zion National Park wrote in National Park Service public feedback obtained by CNN.
The visitor said they saw just one trail crew at the iconic Utah park. There were no educational programs offered at any of the five parks they visited on their trip.
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“Hire back park staff. We need them,” the visitor wrote.
At Yosemite, another visitor said there were no rangers at the Hetch Hetchy reservoir entrance station, preventing visitors from picking up wilderness permits.
“More staff would be a BIG and IMPORTANT improvement,” that visitor wrote.
America’s most treasured national parks are getting crunched by Trump’s government-shrinking layoffs just as the summer travel season gets into full swing.
Top officials vowed to hire thousands of seasonal employees to pick up the slack after the Trump administration fired around 1,000 NPS employees as part of wide-ranging federal firings known as the “Valentine’s Day Massacre.” Department of Interior officials said in a February memo they would aim to hire 7,700 seasonal workers at NPS, and post listings for 9,000 jobs.
But those numbers haven’t materialized ahead July 4th — the parks’ busiest time of the year. Internal National Park Service data provided to CNN by the National Parks Conservation Association shows that about 4,500 seasonal and temporary staff have been hired.
Grok, the AI-powered chatbot…
In reply to купить хороший ноутбук <a… by CharlesIntah (doğrulanmamış)
Grok, the AI-powered chatbot created by Elon Musk’s xAI, has begun pushing antisemitic tropes in its responses to some users’ queries, weeks after Musk said he would rebuild the chatbot because he was unsatisfied with some of its replies that he viewed as too politically correct.
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On Tuesday, Grok connected several antisemitic tropes to an X account with a name it identified as being “Ashkenazi Jewish” that caused controversy with offensive comments posted online about the victims of the recent Texas floods.
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hat surname? Every damn time,” Grok said in response to a user who asked the bot to identify a woman in an unrelated image. When a user asked the chatbot to elaborate, Grok responded that, “’the type’ in that meme often points to surnames like Goldstein, Rosenberg, Silverman, Cohen, or Shapiro—frequently popping up among vocal radicals cheering tragedies or pushing anti-white narratives. Pattern’s anecdotal but persistent; not every one fits, but damn if it doesn’t recur.”
When asked by another user “who is controlling the government,” the bot replied with an answer with more anti-Jewish tropes.
“[T]hat surname? Every damn time,” Grok said in response to a user who asked the bot to identify a woman in an unrelated image. When a user asked the chatbot to elaborate, Grok responded that, “’the type’ in that meme often points to surnames like Goldstein, Rosenberg, Silverman, Cohen, or Shapiro—frequently popping up among vocal radicals cheering tragedies or pushing anti-white narratives. Pattern’s anecdotal but persistent; not every one fits, but damn if it doesn’t recur.”
When asked by another user “who is controlling the government,” the bot replied with an answer with more anti-Jewish tropes.
The levies are also likely…
In reply to купить хороший ноутбук <a… by CharlesIntah (doğrulanmamış)
The levies are also likely to reduce America’s economic output, as has happened before. A 2020 study, based on data from 151 countries, including the US, between 1963-2014, found that tariffs have “persistent adverse effects on the size of the pie,” or the gross domestic product of the country imposing them.
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There are a number of possible explanations for this.
One is that, when tariffs are low or non-existent, the country in question can focus on the kind of economic activities where it has an edge and export those goods and services, Gimber told CNN.
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“If you raise tariffs, you’re not going to see that same level of specialization,” he said, noting that the result would be lower labor productivity. “The labor could be better used elsewhere in the economy, in areas where you have a greater competitive advantage.”
Another reason output falls when tariffs are raised lies in the higher cost of imported inputs, wrote the authors of the 2020 study, most of them International Monetary Fund economists.
Fatas at INSEAD suggested the same reason, providing an example: “So I’m a worker and work in a factory. To produce what we produce we need to import microchips from Taiwan. Those things are more expensive. Together, me and the company, we create less value per hour worked.”
Yet another way tariff hikes can hurt the economy is by disrupting the status quo and fueling uncertainty over the future levels of import taxes. That lack of clarity is particularly acute this year, given the erratic nature of Trump’s trade policy.
Surveys by the National Federation of Independent Business in the US suggest the uncertainty is already weighing on American companies’ willingness to invest. The share of small businesses planning a capital outlay within the next six months hit its lowest level in April since at least April 2020, when Covid was sweeping the globe.
“The economy will continue to stumble along until the major sources of uncertainty (including over tariffs) are resolved. It’s hard to steer a ship in the fog,” the federation said.
Whichever forces may be at work, the IMF, to cite just one example, thinks higher US tariffs will lower the country’s productivity and output.
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Most important, Dauner’s study highlights that not all AI models are created equally, said Sasha Luccioni, the climate lead at AI company Hugging Face, in an email. Users looking to reduce their carbon footprint can be more intentional about which model they chose for which task.
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If you are a software engineer who solves complex coding problems every day, an AI model suited for coding may be necessary. But for the average high school student who wants help with homework, relying on powerful AI tools is like using a nuclear-powered digital calculator.
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When possible, Luccioni recommends going back to basic sources — online encyclopedias and phone calculators — to accomplish simple tasks.
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The study noted that energy consumption can vary based on the user’s proximity to local energy grids and the hardware used to run AI models.
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Currently companies are pretty free to “use the atmosphere as a waste dump,” said Holly Buck, assistant professor of environment and sustainability at the University at Buffalo. “This lack of regulation means there is not yet a strong business case for cleaning this waste up,” she told CNN.
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This should be a “wake-up call,” said Lili Fuhr, director of the fossil economy program at the Center for International Environmental Law. Climeworks’ problems are not “outliers,” she told CNN, “but reflect persistent technical and economic hurdles faced by the direct air capture industry worldwide.”
“The climate crisis demands real action, not speculative tech that overpromises and underdelivers.” she added.
Some of the Climeworks’ problems are “related to normal first-of-a-kind scaling challenges with emerging complex engineering projects,” Buck said.
But the technology has a steep path to becoming cheaper and more efficient, especially with US slashing funding for climate policies, she added. “This kind of policy instability and backtracking on contracts will be terrible for a range of technologies and innovations, not just direct air capture.”
Direct air capture is definitely feasible but its hard, said MIT’s Buck. Whether it succeeds will depend on a slew of factors including technological improvements and creating markets for carbon removals, he said.
“At this point in time, no one really knows how large a role direct air capture will play in the future.”
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President Donald Trump wants to bring back American manufacturing in ways that would reshape the United States economy to look more like China’s. The campaign, which has led to a rapidly escalating trade war with China, has given ample social media fodder to Chinese and American observers alike.
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In a Truth Social post Wednesday, Trump announced that he is raising tariffs on goods imported from China to 125%, up from the 104% that took effect the same day, due to “the lack of respect that China has shown to the World’s Markets.” Higher targeted tariffs on other countries have been paused for 90 days, although the 10% baseline tariff will remain in place for all countries.
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There’s a ‘ghost hurricane’ in the forecast. It could help predict a real one
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A scary-looking weather forecast showing a hurricane hitting the Gulf Coast in the second half of June swirled around social media this week—but don’t panic.
It’s the season’s first “ghost hurricane.”
Similar hype plays out every hurricane season, especially at the beginning: A cherry-picked, worst-case-scenario model run goes viral, but more often than not, will never come to fruition.
Unofficially dubbed “ghost storms” or “ghost hurricanes,” these tropical systems regularly appear in weather models — computer simulations that help meteorologists forecast future conditions — but never seem to manifest in real life.
The model responsible this week was the Global Forecast System, also known as the GFS or American model, run by the National Oceanic and Atmospheric Administration. It’s one of many used by forecasters around the world.
All models have known biases or “quirks” where they tend to overpredict or underpredict certain things. The GFS is known to overpredict tropical storms and hurricanes in longer-term forecasts that look more than a week into the future, which leads to these false alarms. The GFS isn’t alone in this — all models struggle to accurately predict tropical activity that far in advance — but it is notorious for doing so.
For example, the GFS could spit out a prediction for a US hurricane landfall about 10 days from now, only to have that chance completely disappear as the forecast date draws closer. This can occur at any time of the year, but is most frequent during hurricane season — June through November.
It’s exactly what’s been happening over the past week as forecasters keep an eye out for the first storm of the 2025 Atlantic hurricane season.
Why so many ghosts?
No weather forecast model is designed in the exact same way as another, and that’s why each can generate different results with similar data.
The reason the GFS has more false alarms when looking more than a week out than similar models – like Europe’s ECMWF, Canada’s CMC or the United Kingdom’s UKM – is because that’s exactly what it’s programmed to do, according to Alicia Bentley, the global verification project lead of NOAA’s Environmental Modeling Center.
The GFS was built with a “weak parameterized cumulus convection scheme,” according to Bentley. In plain language, that means when the GFS thinks there could be thunderstorms developing in an area where tropical systems are possible – over the oceans – it’s more likely to jump to the conclusion that something tropical will develop than to ignore it.
Other models aren’t built to be quite as sensitive to this phenomenon, and so they don’t show a tropical system until they’re more confident the right conditions are in place, which usually happens when the forecast gets closer in time.
The western Caribbean Sea is one of the GFS’ favorite places to predict a ghost storm. That’s because of the Central American gyre: a large, disorganized area of showers and thunderstorms that rotates over the region and its surrounding water.
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