Good health costs money nowadays. Not everyone can afford to follow and apply the recommendations of the doctors during a medical treatment and the recommendations for a healthy lifestyle, although a survey of Dnevnik daily shows that health is the most important thing for 68% of the Bulgarians. Over EUR 4 billion is spent on healthcare in Bulgaria per year, including the money paid to the health system by the state, the compulsory social security contributions to the National Health Insurance Fund, the voluntary contributions in private insurance companies, as well as payments made by patients for various health services in the hospitals (anesthesia for instance). The sum is even more impressive if we calculate the price of medicines paid by the patients, because the National Health Insurance Fund reimburses only part of their price. In other words, a country with a population of less than 7 million people pays over EUR 4 billion on healthcare, or EUR 200 million more as compared to 2019.

According to statistics, Bulgaria is among the European countries with highest number of ill people, the country with lowest life expectancy and highest mortality rate. The average age of the population is 43.8 years and this ageing population is more vulnerable to diseases and needs more medical care and medicines. According to the National Statistical Institute, in 2017 a total of 2,220,161 Bulgarians were hospitalized in some of the 346 hospitals in this country. 

On paper, the abovementioned amounts are close to the EU average and reach 8.3% of the gross domestic product. However, we must note that according to the media, public spending for healthcare stands at 4.5% of the GDP only and the rest is at the expense of the patients. That is why many Bulgarian hospitals experience financial deficit and the salaries of the Bulgarian doctors and health specialists are low. As a result, the Bulgarian doctors, nurses and patients are not satisfied with the current health system.

Bulgaria’s authorities and the National Health Insurance Fund on one hand and the Bulgarian Medical Association on the other hand negotiate measures, solutions and compromises in this country’s health system during the validity period of the framework agreement. This year the two parties managed to negotiate the main parameters of the health policy in the next three years. According to the new agreement, at least 50% of the monthly revenues of the Bulgarian hospitals must be used for salaries. 64% of this money will go for doctors’ wages and 36% for salaries of the Bulgarian health specialists in the following proportion 1:1.6.

Perhaps we should note that despite the discontent of the Bulgarian patients with the health system, things do not look as bad as some people imagine. For instance, unlike in many European countries, the Bulgarian patient does not have to wait for months to visit a specialist. This happens against the backdrop of the mass migration of thousands of doctors and health specialists to Western Europe in search of better career and living conditions. Tens of thousands of foreign nationals visit Bulgaria for medical treatment or consultations. Their number varies each year. According to latest data, nearly 26,300 foreign citizens visited Bulgaria to receive medical treatment between January and September 2017. According to a survey organized by the Bulgarian Ministry of Tourism, 84% of the foreign citizens who visited Bulgaria said this country is good destination for medical tourism. 60% of the respondents said they were completely satisfied with the medical services they received in Bulgaria. Experts contend that Bulgaria has the necessary potential to become a popular destination for health and medical tourism, because this country has a very well developed network of spa and balneo complexes and offers good value for money.

English version: Kostadin Atanasov