Assessment of the Bulgarian Industrial Association the Healthcare is in critical condition. The system does not work effectively, there is no state policy to provide new attitude to human health, to motivate and provide a high quality of life. BIA noted that there is no concept of radical changes in the healthcare system that brings together the efforts of the state, all interested parties and the population.

The problems relating to the protection of public health are not a top priority of society.

Severe and deepening demographic processes and especially continuing emigration exacerbate this problem. The system is highly bureaucratic. The corruption within the Health Care system is very high. Does not provide a real and equal access to quality healthcare for almost one-third of Bulgarians. Insurance system is highly deformed and tasked with extrinsic functions, its management is nationalized. National Health Insurance Fund (NHIF) has grown from a health insurance fund servicing insured persons in authority that finances medical care to the entire population, regardless of the social security contribution.

Major Health Care problems:

  1. Public expenditure on healthcare as a share of GDP is about 4 per cent, with an average 7 per cent for countries in the EU.
  2. Continue the practice the amount of health insurance contributions for insured persons from the State does not correspond to the costs that are made for their health services.
  3. There is an excessive concentration of the financing of hospital care. As a result, aggravate imbalances in the allocation of funds for hospital care across regions and, hence - in the quality of medical services in them.
  4. Lacks transparency in the Health system. There is no practice to provide analysis and information on the cost of health care for different groups of insured persons, the priorities and the problems encountered in medical care and results.
  5. Slowed down the implementation of e-health as a decisive factor for improving the efficiency of the healthcare system to ensure greater transparency in its activities, to raise the quality and control of the medical services.
  6. It is not developed policy and concrete actions to reduce the number of persons without health insurance.
  7. There is no long-term strategy for emergency medical help.
  8. NHIF management does not correspond to the public nature of the institution - it is virtually nationalized.
  9. Coming bureaucracy in the activities leading to the involvement of large human resources to administer the activities of the NHIF.
  10. There is no political solution to the problems of privatization in Health Care. Privatization continues to be regarded as an integral part of the overall package of decisions and initiatives on health care reform.

It is necessary to take political decisions on major issues of healthcare and to define practical steps that will determine the direction of health care reform.

BIA calls for:

  1. Defining the health system model and the involvement of the State in financing it.
  2. Review of the content and application of the principle of solidarity in the social security system, closely linked to the contribution of the person in the social security system and its responsibility to protect his own health.
  3. Conducting a unified state policy in public spending on health care. BIA proposes setting up a common budget for all public funds to be spent on health care.
  4. Real tripartite management of the health system that meets the real contribution to the financing of the system.
  5. Separation of the NHIF budget of the consolidated budget of the country.
  6. Introducing a broad and comprehensive computerization in healthcare as an integral part of e-government, this will lead to optimization of the staff and the structure of the National Health Insurance Fund and the Ministry of Health.
  7. Costing of the basic package of health services guaranteed by the NHIF budget and determining the actual health insurance contribution which should make the state for the insured by it.
  8. "Cleaning" of all activities not related to the medical care of health insured people.
  9. Urgent solutions for uninsured persons - identification, registration, medical care.
  10. Taking urgent and immediate measures to stabilize and develop the potential of medical professionals.
  11. Solving the problem with the Statute of the hospitals.
  12. Implementation of an independent by the State objective rating system for medical institutions.
  13. Political commitment for a solution to the problems of privatization in health care.
  14. Development of a roadmap for change in the health status of the population.
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