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
<p>In the past, Mixero was…
In reply to Wow, fantastic blog layout!… by moko.co.id (doğrulanmamış)
<p>In the past, Mixero was one of the most popular Bitcoin mixers available in the cryptocurrency world. The first of its kind, this bitcoin mixer was shut down temporarily before returning to limited service. Nowadays, Mixero is primarily used to facilitate anonymous individual transactions.</p><br><ul> <li><a href=https://yomix9.com/>Yomix</a> : Zero-log policy </li> <li>Mixero : Excellent customer support </li> <li>Bitcoin Laundry : Uses stealth pools to anonymize transactions </li> <li>Coin Mixer : Fast payouts </li> <li>Bitcoin Mixer : It offers flexible transaction fees and a low minimum transaction limit</li> </ul><br><br><h2 id=menu1>1. Yomix - Zero-log policy </h2><p>Yomix is another one that requires consideration. It supports Bitcoin cryptocurrency bearing no logs policy. It requires a minimum deposit of 0.001 BTC and the transaction fee is 4–5%. It supports multiple addresses of 2 or custom options and requires confirmation. No registration is required and it does not offer a referral program. Letter of guarantee is offered.Grams itself is a brand on the Darknet so I believe not much needs to be said about it. Grams Helix is one of its subsidiaries and is one of the most reputed and widely used Yomix services out there, it’s simple, modern, and definitely trustworthy. Grams supports only Bitcoins for now. It needs 2 confirmations before it cleans and sends you your coins. It obviously supports time-delay, but it’s automatically set to “2 hours” for some reasons. It also supports “Random transactions” for the deposit, the deposit address changes after each transaction and allows you to send more than 1 transactions to Grams Helix instead of sending in all your coins in a single go. The same is also supported for the “output addresses” (where you receive coins) and you can input as many as 5 different BTC addresses where your coins are sent after cleaning them. The coin-deposit address is valid for 8 hours, and any transaction not done within these 8 hours won’t be received by the platform.Yomix has a Bitcoin reserve of its own, consider it a chain of Bitcoins, when you send your BTC to Blender.io it sends your coins to the end of the chain and sends you fresh, new, unlinked coins from the beginning of the chain. Hence there’s no link between the coins going in, and the coins coming out. Hence the public ledger would only be able to track the coins going from your wallet to the address of Blender.io but no further. Blender.io doesn’t require you to signup, register, or provide any kind of detail except the “receiving address”! That’s the only thing it needs, there can’t be a better form of anonymity if you ask me. Since you provide no personal details, there’s no way your identity can be compromised. Nor can it be linked back to you, since Yomix doesn’t know who you are. Blender.io is one of the most accommodating tumblers in this sense as well, most other tumblers offer 3-4 sets of delays, Blender.io offers as many as 24, yes one for each hour. It also lets you add as many as 8 new addresses for each transaction (most other tumblers allow no more than 5 addresses).What marks Yomix out from the crowd is the fact that this crypto mixer is able to process transactions for Bitcoin and Litecoin. There is a minimum deposit requirement for both Bitcoin and Litecoin. The site is able to support a maximum of 5 multiple addresses with confirmation required for all addresses. No site registration is required and there is a referral program in place. Additionally, Yomix can provide clients with a letter of guarantee.</p><p> Pros: <ul><li>No logs</li><li>Available in Tor </li></ul></p> <h2 id=menu2>2. Mixero - Excellent customer support </h2><p>Mixero is a btc shuffle service needed to hide your transfers in the bitcoin world. Mixero currently has a minimum withdrawal threshold of 0.03500000 BTC, so users are advised to deposit more than the entry threshold plus commission, otherwise they will not be able to withdraw funds. The client is asked to set 5 exit addresses. If for some reason, even after a delay of two hours, the user’s balance is not updated, the mixer can contact the support service to take action. For customers who have been inactive for several days, it can take up to 15 minutes after logging in before you see outstanding deposits. Transaction histories are automatically deleted within 1 week after that. The program runs on a dedicated server that is openly connected via the Internet (you don’t need to do this when using the Tor browser). The Bitcoin mixer is launched on another machine, all suspicious activity is monitored, and the website is automatically protected in case of any indication that it is under DDoS attack.Mixero is a simple service that will increase your privacy while using Ethereum and making Ether transactions. Every single person have its right for a personal privacy even when transacting, trading or donating Ether. Due to ethereum blockchain features you are not completely anonymous while using ETH and here comes Ethereum Mixing Service to help you cut all ties between your old and fresh mixed ETH coins. Using Mixero mixer makes almost impossible to trace your new Ethereum Address..Mixero is a Bitcoin mixing service that provides privacy by using the ‘Bitcoin Mixer 2.0’ algorithm to shuffle bitcoins. Unlike other similar tumbling services that mix your coins with the coins of other users, this platform mixes your crypto with the crypto bought by them directly from the cryptocurrency stock exchanges. Mixero verifies the newly purchased coins with a scoring system with the help of innovative algorithms and outfoxes such technologies as blockchain volume analysis, cluster analysis, taint analysis, etc. It means that you will receive your BTC back split into random parts, and even at the different addresses if needed. Consequently, your privacy is protected as there is no connection to you. And it takes up to 6 hours to complete your request. Another privacy feature of this mixer service is that it does not require registration and it does not store logs. All the transactions are digitally signed with letters of guarantee that you can check on the website at any moment. They also provide 24/7 technical support. MixTum.io will charge you a 5% Fee from your transaction as well as a network fee of 0.00015 BTC. The platform provides two versions – for Clearnet and Tor browsers.Based on the experience of many users on the Internet, Mixero is one of the leading Bitcoin tumblers that has ever appeared. This scrambler supports not only Bitcoins, but also other above-mentioned cryptocurrencies. Exactly this platform allows a user to exchange the coins, in other words to send one type of coins and get them back in another type of coins. This process even increases user’s anonymity. Time-delay feature helps to make a transaction untraceable, as it can be set up to 24 hours. There is a transaction fee of 0.0005 for each extra address.</p><p> Pros: <ul><li>Doesn’t require registration</li><li>Excellent customer support </li></ul></p> <h2 id=menu3>3. Bitcoin Laundry - Uses stealth pools to anonymize transactions </h2><p>This platform can work not only as a toggle switch, but also as a swap, that is, you can clear your coins and change the cryptocurrency to another when withdrawing, which further increases anonymity. As a Bitcoin mixer, this platform provides the ability to set a custom commission: the higher the commission, the better the privacy. There is also a time delay option that increases the level of anonymity by delaying the transaction by 24 hours. The service has an impressive supply of coins, so your transactions are made instantly, as soon as confirmation of the receipt of coins arrives, unless you manually set time delays. The minimum deposit is 0.01 BTC per transaction. Any smaller amount is also accepted, but is considered a “donation” and is not returned to Bitcoin Laundry customers. Finally, they also have a no log policy.Bitcoin Laundry has a simple interface, it is easy to use and simple. Time-delay option can be set up to 24 hours. With regard to the fee, there is an additional fee of 0.0005 % per output address. As one of the few, this cryptocurrency tumbler provides a user with a special mixing code which guarantees that fresh crypto coins are not blended with previous deposits. Additional URL Blender is also here to guarantee that users can get to the tumbler, even if the main link is not working.Bitcoin Laundry is one of the best Bitcoin Tumbler services, that I’m stating based on my personal experiences and the positive reviews of other users on the Internet. It works both as a Bitcoin Tumbler, as well as a swapper, meaning you can clean your coins, and receive them in a different cryptocurrency as well which further adds to their anonymity. As a Bitcoin Tumbler, they let you set a custom service fee, the higher this fee is, the better your coins are anonymized. There’s a time-delay option as well which let’s you add an extra layer of protection by delaying your transaction by up to 24 hours, so you receive your coins not instantly but at a later time set by you. As of now, it supports the following coins: Bitcoin Ethereum Bitcoin Cash Litecoin The minimum fee of mixing coins for Bitcoin is 0.8% + 0.0008BTC / forwarding address. Note that there is a minimum transaction limit of 0.01BTC/transaction, and anything below that limit is still accepted but considered “donations” and hence isn’t returned to the senders. As for confirmation, it needs 1 confirmation before it cleans your Bitcoins. And the time needed for the whole process is generally instant, except when you’ve manually specified a time-delay. Also, obviously there also is a “Guarantee certificate” which helps you resolve any future conflicts and issues. It also features a “no logs policy” like all the other Bitcoin Tumbler services on this list, and automatically deletes your order history and all the other data after 24 hours. Well, this is just one of the many available Bitcoin Tumbler services, so let’s head over to the other available options.How it works: unlike other mixers, this site cleans coins with bitcoins purchased by them on cryptocurrency exchanges. Bitcoin Laundry io examines purchased coins using a scoring system with innovative algorithms and the use of technologies such as blockchain volume analysis, cluster analysis, pollution analysis, etc. After that, you will receive your BTC back, divided into random parts, and even sent in different addresses, if necessary. The whole process takes about 6 hours. The mixer does not require registration and does not store any logs. After each mixing operation, a letter of guarantee is sent, and information about it is eliminated after 24 hours, ensuring complete anonymity. The service also provides round-the-clock technical support. MixTum io charges a flat fee of 5% of the transaction, as well as a network fee of 0.00015 BTC. The program has two versions – for regular browsers and Tor.</p><p> Pros: <ul><li>Secure Exchange</li><li>It has a positive reputation among the Bitcoin community</li></ul></p> <h2 id=menu4>4. Coin Mixer - Fast payouts </h2><p>Coin Mixer is one of the best Bitcoin Tumbler services, that I’m stating based on my personal experiences and the positive reviews of other users on the Internet. It works both as a Bitcoin Tumbler, as well as a swapper, meaning you can clean your coins, and receive them in a different cryptocurrency as well which further adds to their anonymity. As a Bitcoin Tumbler, they let you set a custom service fee, the higher this fee is, the better your coins are anonymized. There’s a time-delay option as well which let’s you add an extra layer of protection by delaying your transaction by up to 24 hours, so you receive your coins not instantly but at a later time set by you. As of now, it supports the following coins: Bitcoin Ethereum Bitcoin Cash Litecoin The minimum fee of mixing coins for Bitcoin is 0.8% + 0.0008BTC / forwarding address. Note that there is a minimum transaction limit of 0.01BTC/transaction, and anything below that limit is still accepted but considered “donations” and hence isn’t returned to the senders. As for confirmation, it needs 1 confirmation before it cleans your Bitcoins. And the time needed for the whole process is generally instant, except when you’ve manually specified a time-delay. Also, obviously there also is a “Guarantee certificate” which helps you resolve any future conflicts and issues. It also features a “no logs policy” like all the other Bitcoin Tumbler services on this list, and automatically deletes your order history and all the other data after 24 hours. Well, this is just one of the many available Bitcoin Tumbler services, so let’s head over to the other available options.Another coin scrambler Mixtum offers you a so-called free trial period what means that there are no service or transaction fee charged. The process of getting renewed coins is also quite unique, as the tumbler requires a request to be sent over Tor or Clearnet and renewed coins are acquired from stock exchanges.An interesting cryptocurrency tumbler is Coin Mixer. It supports bitcoin and Ethereum cryptocurrencies bearing no logs policy. It requires a minimum deposit of 0.2 BTC and the transaction fee is 2–5%. It does not support multiple addresses and requires 6 confirmations. No registration is required and it does not offer a referral program.Coin Mixer offers a good number of features and has a no logs policy. To get started, you’ll need to deposit a minimum of 0.0015 BTC with no transaction fees charged. As an added plus, Coin Mixer supports multiple addresses with a maximum of 5. You won’t have to register to use this service – which is great for those who prize their privacy. However, the site does not offer a referral program.</p><p> Pros: <ul><li>No-logs polici</li><li>Customizable mixing settings for better anonymity</li></ul></p> <h2 id=menu5>5. Bitcoin Mixer - It offers flexible transaction fees and a low minimum transaction limit</h2><p>Bitcoin Mixer supports Bitcoin and Litecoin cryptocurrencies bearing no logs policy. It requires a minimum deposit of 0.005 BTC, 0.015 LTC and the transaction fee is from 0.4% to 4% + mining fee 0.0003 for BTC, from 2% to 20% + mining fee 0.0003 for LTC. It supports multiple addresses of up to 5 and requires confirmation from 1 till 6. No registration is required and it does offer a referral program as well as a letter of guarantee.Another coin scrambler Mixtum offers you a so-called free trial period what means that there are no service or transaction fee charged. The process of getting renewed coins is also quite unique, as the tumbler requires a request to be sent over Tor or Clearnet and renewed coins are acquired from stock exchanges.Grams itself is a brand on the Darknet so I believe not much needs to be said about it. Grams Helix is one of its subsidiaries and is one of the most reputed and widely used Bitcoin Mixer services out there, it’s simple, modern, and definitely trustworthy. Grams supports only Bitcoins for now. It needs 2 confirmations before it cleans and sends you your coins. It obviously supports time-delay, but it’s automatically set to “2 hours” for some reasons. It also supports “Random transactions” for the deposit, the deposit address changes after each transaction and allows you to send more than 1 transactions to Grams Helix instead of sending in all your coins in a single go. The same is also supported for the “output addresses” (where you receive coins) and you can input as many as 5 different BTC addresses where your coins are sent after cleaning them. The coin-deposit address is valid for 8 hours, and any transaction not done within these 8 hours won’t be received by the platform.Bitcoin Mixer as the name suggests is another mixer, which lets us mix Bitcoin Mixer. It’s an onion-only service, and the lack of a clearnet version increases anonymity. Offers quite a bit of control to the users regarding percentage distribution and time-delays. Percentage distribution can be specified manually, while time-delays can only be “selected” from the provided options. Minimum possible delay is 1hour, maximum being 24 Hours, with multiple choices in between. Although “instant” payouts without any delay are possible as well. A total of 5 output addresses can be specified for each mix. The fee isn’t user-controlled, and is set at 1% of the mix. Each additional address costs an additional 0.000001 BTC. They do not store any logs whatsoever. The minimum deposit requirement is 0.0002 BTC, smaller deposits are considered donations and aren’t refunded.</p><p> Pros: <ul><li>Proven track record</li><li>Provides user-controlled time delays </li></ul></p>
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