The City of Skopje will pay one-off financial assistance to 456 cancer patients over the next two days. Mayor Orce Gjorgjievski announced that the money will be transferred to their accounts, and that processing of the remaining applications will be completed over the coming week.

The number worth holding onto is a different one: 1,200 citizens applied.

Twelve hundred people on a single application scheme

That is not a statistic about the city administration - it is a statistic about the health system. Twelve hundred cancer patients in one city filed a request for one-off aid from a local authority. Not for treatment, not for medication, not for therapy - for money.

When that many people seek financial support from a city, it means some other part of the system is failing to cover something it ought to be covering. Oncology is the field where the gap between what is officially covered and what the patient actually pays is at its widest - travel to the clinic, drugs that are not on the approved list, income lost while the therapy runs.

"When life confronts us with the hardest challenges, our humanity is measured by our readiness to extend a hand," Gjorgjievski said. The sentence is accurate and well meant. The aid is real, and for 456 families tomorrow will be easier.

But aid is not a system

A one-off payment from the city is a good thing and not something to criticise - the thing to ask is why it is needed on this scale. If 1,200 cancer patients in Skopje need one-off assistance, the question is not whether the city processes applications efficiently, but what the Health Insurance Fund is doing.

The city is paying. The state should explain why it has to.