Financing of the Bulgarian healthcare system is obviously completely wrong, but the leading players in the system are trying their best to postpone emergency measures for better times. Caretaker Minister of Health Prof. Nikolay Petrov held a meeting with the manager of the National Health Insurance Fund Dr. Plamen Cekov, members of the supervisory board of the institution and the leadership of the Bulgarian Medical Association. The meeting was supposed to discuss urgent changes in the payment methodology for hospitals, but it turned out that the rendez-vous was more of a networking character. The worst part is that after all nobody understood
what is the scheme for payment today
of state, municipal and private clinics. Mr Tzekov avoided any answers to questions that were inconvenient, supervisors voted for a method but could not explain exactly what, and the professional organization still wants something, but no one takes it seriously. In the meanwhile, the ship of healthcare system will probably break in the first encountered reef.
No one dares to acknowledge whether (and by how much) the hospital budgets for 2013 have been sliced. According to forecasts, they had to spend last year 1.2 billion levs, but were actually paid for their activities by 200 million lev on top of that sum. This year the stake is roughly the same, but the market welcomed several large hospitals that also want a piece of the pie. The health insurance fund on its own created conditions for chaos and tension with the decision that in future clinics may not exceed the assigned sums for their annual activity by more than 5 per cent. Then its appeared that the budgets of some are permanently reduced by Mr. Tzekov by 10 to 30%, but partially offset (by only 22 million levs) were only five major hospitals in the capital, which quite naturally raised an intense discontent.
After the summit member of the supervisory board of the NHIF, Dr. Ivan Kokalov, said that when health ministers stop giving licenses to new hospitals, there will be no cuts in the budgets of the old ones. In Sofia there are several new clinics in Varna and Burgas, too. They have a legal right to ask for money that we have to take from the rest, he said
Chairman of the Bulgarian Medical Association, Dr Vladimir Borozanov, claims that hospital budgets for 2013 are severely trimmed, and the health insurance has not reintroduced the last year’s method of financing hospital care. It was not clear what documents are valid and which figure from 2012 was taken by the fund – the actually incurred expenses of the hospitals or the planned ones.
Without consistent agreement with patients and pharmacists, the health ministry has proposed an even more inappropriate freezing. According to a draft bill, the
free sale drug prices
will be adjusted for a year, and the decision should take effect in about a month. In the words of Minister Nickolay Petrov, this way the interim government would prove its social orientation. However, this is a double edged sword and, for example, painkillers, drugs against colds and flu as well as vitamins may suddenly turn out to be far more expensive than they are now. First, their manufacturers have plenty of time to raise prices for the year ahead, and separately they can make further adjustments taking into account the inflation rate.
Pharmaceutical Association and the generic manufacturers were extremely surprised by the proposal because it was never discussed in the working groups that prepared the ordinance to regulate the prices of medicines. Not to mention that the new National Council on prices and reimbursement of medicines that is there to validate and record prices, including new drugs, in the Positive Drug List as well as to control the sale of drugs approved rates should have started to operate.
The BANKER
