Sixteen cardiologists and cardiac surgeons from state hospitals in North Macedonia have warned that at least eight patients underwent unnecessary operations in a private clinic, with costs covered by the state Health Insurance Fund (HIF).
In a document sent to the health ministry and the HIF, the doctors said the procedures showed “irregularities in the indications for surgical treatment,” meaning there was no genuine medical reason for the interventions, according to evidence-based medicine.
The disputed cases involved traditional cardiac surgeries rather than stenting, which is not covered under contracts with private clinics. It remains unclear why the operations were not performed at the state cardiac surgery clinic.
Doctors noted that in the past, surgeries could only be billed to the HIF if five state cardiologists confirmed the medical necessity, but that control system has since been abolished. Some voiced suspicion that the change weakened the capacities of the state cardiac surgery and cardiology clinics in Skopje.
“What we need now is to reinstate a mechanism of control, whether with domestic or foreign experts,” one signatory said, adding that medical imaging could be assessed electronically.
Weekly magazine Fokus reported that such cases have drained millions of euros annually from the HIF. Doctors warned that beyond the financial damage, invasive procedures without medical justification carry severe health risks, including death.