MANY QUESTIONS ARISE ABOUT HEALTH INSURANCE INSTALMENTS
It was a complete mess in doctors' cabinets, hospitals, and pharmacies last week because of the unpaid health insurance instalments. More than two million Bulgarians keep waiting in fear for the creation of a fair solution to the problem. Driven into a corner, state officials on whom this solution depends decided to adopt the Greek model for defining the healthcare rights of the patients. The Ministry of Healthcare proposed that people who have missed more than three payments in the past fifteen months must pay for getting medical aid in the future. (So far, free treatment was denied to people who had missed more than three monthly instalments, regardless of the period.) However, the proposal does not solve the numerous existing problems and even provokes further questions that need an answer as soon as possible. It is not clear yet whether the debtors will be allowed to use the privileges of the regular payers if they pay all instalments due to the National Social Security Institute for the past 15 months or will need to pay all the money due. If there is a chance for them to only pay the money for a year and a half, there is no guarantee that those owing money for longer periods will ever pay them to the institute. What is more, nobody answered the question if there will be changes in the requirement that all payments to the institute must be carried out before the end of 2004. There is another problem with the Bulgarians who live abroad as they represent a significant part of the improper payers. The Minister of Healthcare Slavcho Bogoev proposed that Bulgarians who live abroad for more than six months in one calendar year should not pay health insurance instalments until they return to the country. However, the experts from the ministry have not yet decided how many instalments former immigrants will owe to the institute in order to regain their healthcare rights.It is also unclear how Bulgarians whose instalments will be paid by the state will be chosen. According to the Minister of Labour and Social Policy Hristina Hristova, the people whose income goes 10% beyond the barrier for access to the social benefits system must get healthcare reliefs, too. A special fund will therefore be established in the ministry which will provide the necessary funds. It is certain that the state will begin to make payments from the beginning of next year but what will happen to the old debts of poor people is not known yet. A method for their cancellation will have to be found out sooner or later, experts claim. However, this can only be done with an act issued either by the President or the National Assembly. According to the Bulgarian Economic Chamber, the debts accumulated so far should be paid off with money from the reserve of the National Healthcare Insurance Fund. Improper payers and employers should be traced by the State Receivables Collections Agency, the organisation proposed.People who work on the basis of labour contracts and are registered in the National Social Security Institute remain in the most favourable condition. The Minister of Economy Lidiya Shouleva promised that even if a company had not paid health insurance instalments its employees would not be deprived of their healthcare rights. Sanctions will be discussed for the incorrect employers. Unscrupulous people who have a certain income and do not pay their instalments regularly will have to pay big fines apart from the accumulated interests.