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February - 2005


Arguably there are two types of illegal payments common in an average developing country such as Romania, white bribery and black bribery.
Some can see white bribery as a necessary measure to transgress a particularly stupid law, including speeding up the administrative process with a casual back-hander to a minor public servant who has to abide by an idiotic regulation, or failing to acknowledge the entire assets of a small and medium enterprise that cannot function in over-stringent tax conditions.
This is making sure the individual receives what he or she needs in an acceptable time frame without suffering an unfair penalty. Criminal and unacceptable it may be, but this is also understandable and usually the
impetus for changes in legislation. Black bribery is an active form of corruption, such as a business paying a local council packages of cash to secure a favourable result in a public tender, a payment to a policeman to ensure he does not prosecute drunken driving or to a teacher for good marks. This has the opposite effect of white bribery, because it perpetuates an unfair and uncompetitive practice and brings the public sector into disrepute.
But where does this leave the routine payments to doctors and nurses in public hospitals for treatment? In Romania, it is often necessary for patients and their families to pay for healthcare with negotiated prices, which, as we have been quoted, include between 100 and 300 Euro to fix a broken leg or 100 Euro for an appendix operation. If the patient fails to raise the cash, he or she could be ignored or, at worst, risk a potentially crippling operation.
In one sense this is black bribery because it denigrates fairness and with every further payment the problem of endemic corruption is exacerbated. Alternatively this is white bribery, because the citizen has no choice as his or her selfpreservation is at stake. Looking for someone to blame for such moral and physical abuse, one could point the finger at the doctors and nurses, as it has become a standard procedure in many hospitals as acceptable as the changing of bed linen after a patient has died, or washing one's hands before an operation. But as we examine in our special on healthcare, things are not that simple.
To a certain extent it is up to Government will and the medicalprofession itself to reduce such an institutionalised form of corruption, as people have no choice but to pay.
But this everyday process undermines all notions of a civil society and will affect, at some point in their lives, every citizen. With a system that claims to be free at the point of access, it becomes the most expensive purchase a large number of Romanians will ever make. If the health of the people is the highest law, this is the most serious and widespread crime currently being undertaken in Romania.