Health system’s liberalization schedule

In reply, Bazac presented the steps which are to be taken for decentralizing and increasing the flexibility of the health care system. The Health Minister announced that he will introduce co-payment for public medical services as of 1 July. Part of the additional attracted funds will represent an investment resource for hospitals, while the remainder will go to medical service providers.

“Hospitals will have to fight to obtain financing. What this system lacks is competition. This is the only system where there is no competition,” Bazac said.

The President of the National House for Health Insurance, Irinel Popescu, said that the co-payment system could overlap with the informal payment system, and actually put more pressure on tax payers. Popescu added that private health insurance is the financial resource which can raise health financing to eight percent of gross domestic product (GDP), which is the European health budget average, from the present 3.8 percent of GDP. The official indicated that the co-payment system will filter patients, so that they will no longer go directly to hospitals.

“Private insurance would take us from four to eight percent of GDP. I see co-payment as a disciplinary mechanism, with hospitals less crowded,” Popescu added.

Moreover, Bazac said that the minimum medical service package covered by the state is to become available on the market as of 1 September. “We are working on the general package. Before defining it we must begin quantifying costs. We started working on therapeutic guides and protocols for top 10 pathologies and to quantify costs, which are the basis for defining the minimum service package,” said the Health Minister.

The Minister is also working on modifying the public-private partnership law, so that private investments can be attracted for the state health system.

“In a system with 4.7 million tax payers and almost 20 million consumers, in which contributions dropped threefold over the past year, there is a wide gap between expenses and revenues. We cannot afford hospitals whose personnel costs amount to 80 percent, and 12 of 431 hospitals that are swallowing up 80 percent of revenues,” Bazac added. The members of the Private Government, namely the health sector business community, worked on a set of recommendations in October that could unblock medical system inertia.

The price of medications dropped an average one tenth as of 1 April, once a new price calculation methodology by the Ministry of Health went into effect. According to law, prices for prescribed medicines are set by state authorities, while the prices of non-prescription drugs are set based on market rules.