The situation in the National Health Insurance Fund (NHIF) is hopeless, since the team led by Dr. R. Todorova has to deal with at least a 150-million budget deficit, and yet an outside help is not coming. Its only alternative is to bring in rough play. Pressed to the wall, the managers of the Fund are clearly determined to use their entire arsenal of (not) allowed maneuvers.
The team of health experts from NHIF each day tightens the rope around the hands of medical institutions. As it goes, hospitals will continue welcoming more healthcare inspectors than patients. With the idea to distribute the funds more correctly among hospitals, the supervisory board of the NHIF decided by the first of April 2014 to set the budgets of hospitals with which it has contracts on a monthly basis. Annual financial forecasts and planning based on past records will remain in history. According to the Chairman of the Supervisory Board, Dr. Boyko Penkov, the new methodology will be more flexible in its estimates as the monthly analysis would show where it is urgently needed to transfer more funds to.
The „ingenious“ scheme, which incidentally was created in complete violation of the NHIF’s Budget Act for 2014 most likely will cause
even greater chaos with the money for hospitals.
Under the existing law clinics are obliged to report on the work done by the tenth day of the following month. It must take at least another week in which their paperwork is transferred from the regional health insurance funds to NHIF headquarters to be processed. It turns out that the Supervisory Board will approve „in the dark“ the budgets for the current month, which is almost at its end at the time of approval. So far, hospitals have been transferring part of their funds within the respective quarter of the year and somehow managed to balance the flow, but in the future they will be even more compelled to fib in order to guarantee themselves a certain amount. Directors will enter in a frantic race for patients. Episodes such as the cancer patient who fell unconscious on the street, and who on papers is being treated under a clinical pathway for thousands of dollars in a private clinic, while in the same time is receiving emergency aid in Sofia’s Pirogov, are likely to become routine. Or worse – mass clinics will stimulate – through consultancy contracts – the GPs to send to them patients for high-priced research and operations, but these will be patients who do not need these procedures in fact. So NHIF will in fact increase rather than reduce costs. Not to mention that the health of thousands of people will be under serious threat.
The BANKER
