Dr. Tsvetan Raychinov, Chairman of the Bulgarian Medical Association: Healthcare contributions in our country are the lowest in Europe

Sonia Stamboliyska

Dr. Raychinov, how would you comment on the decision of the Government to increase healthcare contributions by 2%?
The position of the Bulgarian Medical Association is that health funding is insufficient. The financial schemes and ideas which will secure sufficient resources are a matter of political decisions. In this sense, we support all measures which will increase resources, so that we can guarantee high-quality, affordable healthcare for real. I cannot say, however, because I am not a financial expert, whether this is the best way to increase funds in the system. This is a decision to be made by the Government. It is true that healthcare contributions in Bulgaria are probably the lowest in the EU. The second thing is that the budget of the National Health Insurance Fund (NHIF) amounts to €800 mln. This is the average annual budget of a medium-size European hospital. And this is the amount we have allocated for the entire country and all its citizens

Will this raise in contributions actually increase resources in the system?
There should be more resources in the system. Otherwise, what is the purpose of increasing contributions and improving revenue collection if the money which flows into the system is spent on something else. At least, the PM said explicitly that these funds will be allocated strictly for the healthcare system. I cannot say how much funds will increase due to the raise in contributions because these estimates are made by financial experts. 

Why did the government decide to increase healthcare contributions this year when the initial plan was for the raise to be introduced next year?
I believe the only reason is the fact that the system lacks sufficient funds. No one can provide healthcare services when they have at their disposal a mere BGN 1.6 bn. Not in a country with a population of between 7 and 8 million people. The funds are insufficient and this has been known for many years.

The Cabinet is expected to release the reserve of NHIF today. What will these funds be spent on?
This money will be remitted to the budget of NHIF. It is clear even now that the major part of the funds will be allocated for hospital care since this is the sector most in need. I cannot say whether all the funding will be allocated for that purpose because it is a matter of estimates which NHIF should make and submit to us.

Why do the protests of GPs continue considering the fact that the Government promised to allocate more money to the system?
People are disappointed now because their payments have been deferred for three consecutive months and they have been left without any money. Although promises were made that they will be paid, belatedly, this month, they do not believe that they will receive the amounts due on time next month. Most of them are convinced that this is just a temporary measure to stop the protests. We joined the protest; they are just a little more active and free and, therefore, react first. All the issues they want to be resolved apply to other physicians as well. I have appealed, for some time now, for setting a deadline to the government to fulfill its promises but I cannot tell physicians what to do. These commitments and promises are made on Monday, and they cannot be fulfilled in a single day. The only thing that can happen quickly is for the amounts due for January to be remitted. By the end of the week, all claims must be covered and, by the end of March, all amounts due for February should have been paid out.