Health contributions in Bulgaria should be increased to at least 10% in order to improve the quality of the service, but this should only happen after a review of the solidarity in the system and a clear prediction of who pays what. This was said by Krasimir Grudev, chairman of the Board of the National Hospital of Ukraine, member of the Board of the European Association of Hospitals and Healthcare, on the air of the program “Business Start” with host Roselina Petkova.
“For us, the existing situation is scandalous that civil servants do not pay insurances themselves, but these contributions are paid by the departments… When we have clear traceability of who pays what insurances, whether personally or through the employer, we can predict what money will are collected. Otherwise, very often, payments from the state to the health insurance fund are formed on a residual basis… Before we get to increasing the percentage of contributions, we must first correct these irregularities,” the guest is emphatic.
The average health insurance contribution in Europe is 10% and Bulgaria should strive for at least this level, Grudev believes.
Despite the efforts made to develop and adopt higher levels of preventive care among the population, this is not happening because of the overcrowding of general practitioners (there are only 4,500 of the 6,000 needed) and the traditional disinterest of Bulgarians, Grudev said.
According to him, perhaps measures should be introduced to make prevention mandatory and with certain criminal sanctions, when a person does not take his prevention seriously – if he does not go for regular check-ups, he will not be entitled to certain things.
Timely diagnosis of diseases, which occurs during preventive examinations, will help reduce the burden on the health care system, but will ensure greater survival of diseases at a lower cost, Grudev said.
For the past 30 years, over 1.5 billion BGN investments have been made in private hospital healthcare for over 120 high-tech hospitals, Grudev said.
“Private hospitals have created much-needed competition in the hospital market, which is the most serious and significant factor for the development of medical care,” he believes.
Health care in the country must be universally accessible, with high quality and the necessary timeliness and speed of treatment, which, according to Grudev, private hospitals manage to provide to a large extent. About a third of the country’s hospitals are private (with about a third of hospital beds), and the rest are split equally between municipal and mixed state-municipal, he added.
The situation in the system is stable, although it is working without a budget for 2023, and expectations are for about 10%-12% growth of the budget due to the natural increase of revenues through the growth of salaries and insurances, Grudev said.
There is a shortage of staff in the system due to an outflow of candidates for the medical profession, most prominently in nursing. This is the situation throughout Europe, as in Bulgaria the doctor/nurse ratio is 1:0.8, and the normal level is 2:1. There should be a targeted policy and business approaches to keep staff in the country, Grudev said, and gave the example of scholarship programs for training in exchange for a commitment to work for a period of time.
“Specialization opportunities such as places of specialization should also be increased. Few steps have been taken in this direction – one can specialize in smaller hospitals, including private hospitals, and it should be continued. In our opinion, the professional empowering nurses to perform more functions, to also have the prospect of personal professional growth and to be able to replace the lack of doctors.”
How the healthcare system will change with the introduction of insurance companies can be seen in the video of Bloomberg TV Bulgaria
