A dramatic appeal of patients with a stoma. “Nobody healthy can imagine going to the toilet once every two days”

A stoma is a surgically made connection between the digestive tract or urinary tract and the skin to pass stool or urine if it cannot be done naturally. To make this possible, you need specialized medical equipment that is regularly replaced. The Ministry of Health wants to introduce changes in its reimbursement, which met with opposition from the community of people with a stoma. There are almost 64 thousand of them in Poland.

1. Stoma emergence procedures are most often performed in cancer patients and the elderly, but a stoma can also result from inflammatory diseases, accidents, perinatal complications or birth defects.
2. Patients with a stoma use equipment, the elements of which are, among others bags, plates and care products
3. Most of them are reimbursed, but the health ministry wants to withdraw some of the subsidies
4. The STOMAlife Foundation, on behalf of the Polish ostomy community, is appealing to withdraw from the project or change the proposal. Below we present the content of the letter we received from the foundation
5. You can find more such stories on the TvoiLokony home page

Who in Poland has a stoma?

Currently, nearly 64 thousand people live in Poland. stomics, and about 13 are performed every year. treatments for subsequent stomas. Most stoma patients, even if they are economically active, earn below the national average, and some remain unemployed as a result of social exclusion related to the disease. The others are retired or on a pension.

Over 63 percent people with a stoma are cancer patients, seniors or people who have been ill since childhood. The emergence of stoma is also a consequence of inflammatory diseases of the digestive system, traffic accidents and perinatal complications.

Apart from the stoma, patients and their caregivers have one thing in common: coping with everyday life and financial problems. Today they face another blow to their dignity and wallets.

The health ministry wants to withdraw from the reimbursement of ostomy equipment

On July 8, 2022, the Ministry of Health (Ministry of Health) published a regulation amending the regulation on the list of medical devices issued on request. Thus, it announces radical, negative changes in the reimbursement of ostomy appliances.

It would seem that we live in a time where the use of the toilet and hygiene activities are guaranteed and are not a luxury, but a basic human right. A stoma is a type of invisible disability. It is worth emphasizing that ostomy appliances are single-use appliances and their use cannot be interrupted or replaced with anything else. The patient must be provided for 24 hours. a day, 365 days a year. Ensuring continuous and free access to high-quality equipment is a must in the struggle of ostomates to maintain a dignified life.

The STOMAlife Foundation, representing the community of 64 thousand Polish dentists would like to express a strong protest against the proposed solutions, which will not improve the situation of ostomates, and in many cases will dramatically worsen it. Stomics loudly ask to stop the changes proposed by the Ministry of Health.

Stomics were given 21 days from July 8, 2022 to consult the project. Therefore we cannot be silent! It’s time to act.

The proposed project radically changes the method of reimbursement of ordered ostomy products. The current value limits have not been revalued since 2003, and additionally, the price of products increased by 7%. VAT in 2004 and 8 percent. VAT since 2011

The Ministry of Health has been informed for a long time that the current formula is insufficient to function properly. By writing straightforwardly: no healthy person can imagine going to the toilet once every two days, or at best once a day! In 2012, the Ministry of Health withdrew from the reimbursement of ostomy care products, limiting itself only to financing plates and bags. After the intervention of the ostomy community, after a few months of ordeal and translations, the products returned to the list! Therefore, we believe that the preach of ostomates and their loved ones will be heard.

The project submitted for consultation assumes:

1. Potential surcharge for the collected ostomy equipment in the amount of 10%, respectively. – bags and plates, 20 percent – care products. Children remain without subsidies, but no one has specified the child’s age, and it is defined differently in various legal acts.
2. Limited reimbursement for paste only care products once a month or 15 rings or 30 half-rings and wipes (30) or adhesive spray (1). This means that nothing except the aforementioned measures will be refunded, i.e. second skin preparations, fixing strips, foams, gels, powders, protective and healing plates.
3. No sealants are reimbursed in the case of a colostomy.
4. Limiting the possibility of continuation of orders by nurses and midwives – the possibility of continuation for six months, not 12 months as before.
5. Patients with additional authorization codes will also pay extra.
6. The project does not distinguish between a flat plate and a convex type, which are assumed to be more expensive, which with such a record will result in a much higher payment for the patient, apart from 10%.
7. When calculating the base of the limit, the project refers to prices that are not currently available on the market, which actually means much higher surcharges for patients than mentioned in the project.

“The chance for a dignified life will be lost!”

Having experience with the current system, we believe that splitting into four separate orders will limit the free access of the stoma to high-quality equipment and building a basket as needed depending on the stoma you have. In addition, he puts a lot of work both in writing orders, as well as their implementation.

Without going into details, it can be said that the surcharges will be much higher due to the prices of ostomy products. In addition to the surcharge, the stomik will have to pay the full difference between the set reimbursement price and the price of the product!

Based on the published draft and referring to the current market prices, it can be concluded that the monthly surcharges will reach even PLN 750. This amount does not yet include expenditure on products that are not reimbursed by the project, such as stoma paste or sealing rings in the case of a colostomy, and a protective preparation such as a second skin, healing powder, sealing gels, etc.

It should be emphasized that a large group of stomas are people suffering from cancer, which means a significant burden on the household budget, and, as the data shows, even now stomas resign from buying equipment for cash, apart from the reimbursement order, because they simply cannot afford it.

If these proposals come into force, then, as proposed, it will lead to many complications resulting from insufficient supply, because stomas simply cannot afford subsidies. As a consequence, this may lead to the withdrawal of ostomates from social and professional life. What the Foundation and the stomates themselves have been fighting for for years, i.e. the chance for a dignified life, will be lost!

Stomics, whose daily budget is burdened by expensive treatment, face many problems. Only a full refund of equipment will enable ostomates to continue to function actively in society. The current reimbursement amounts do not allow you to receive enough equipment free of charge, as a patient may receive on average less than one bag per day. It should be remembered that improperly selected equipment or its insufficient amount lead to dangerous complications such as necrosis, fistulas, peristomal hernia, painful burns and wounds.

In extreme cases, treatment of complications requires outpatient or even inpatient treatment, which generates additional costs for the state budget (!), Which is worth noting – higher than those that would be reimbursed.

Further cuts in government spending on ostomy appliances could disastrously worsen the already plight of patients. Currently, Mr.about two-thirds of them resign from professional activity, and 87 percent. ostomates feel anxious about returning to social life. Assuming the necessity to pay even a partial payment for equipment, the number of people resigning from their professional life will increase significantly, and thus the state costs related to their maintenance will increase. Social insurance expenses, e.g. for the lowest pension per year, are over PLN 10. PLN, which is three times the amount of reimbursement of the annual supply of colostomy equipment.

What do ostomates really need?

In order for stomas to fully recover from stoma surgery, certain conditions must be met:

1. Free access to high-quality ostomy equipment, according to individual needs.
2. Defining ostomy appliances as: ostomy bags, wafers, specialized hygiene measures and proper protection of the stoma and the skin around it.
3. The possibility of selecting the type and amount of equipment according to the individual needs of individual people, based on the decisions of a professional, i.e. a doctor or an ostomy nurse. Easy and free access to ostomy clinics that guarantee professional advice.

The STOMAlife Foundation has proposals for the reimbursement of ostomy appliances:

1. Maintaining the current method of reimbursement – the possibility of individual selection of supplies for a specific reimbursement value without co-financing by people with an identified stoma.
2. Urealnienie limitów stomijnych:

1. colostomy – PLN 450,
2. ileostomy – PLN 600,
3. urostomy – PLN 650.

3. Ensuring the availability of high-quality ostomy equipment, taking into account the possibility of personalized selection of supplies.

4. Full refund of basic equipment, plates and bags as well as care products.

I would like to ask you for the support of your stomas already at the stage of project consultation. Sign under the “NO petition for the Ministry of Health project on the method of reimbursement of STOMIC equipment: NOT for the project of the Ministry of Health on the method of refund of equipment”. Send your opinion / remark via ePUAP or via e-mail to the address of the Parliamentary Health Committee to your deputies and senators. Contact the STOMAlife Foundation through the Facebook page.

STOMAlife Foundation

Dorota Ask

Chairman of the Board

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