Банкеръ Weekly



An inadequate draft bill is about to send Bulgarian healthcare system back to its level in the 1980s. The draft may force patients to pay by themselves up to 90% of the value of the medical services despite their regularly paid monthly healthcare installments. The dark forecast was made by Dr. Atanas Kundurdzhiev, Chief Secretary of the Bulgarian Doctors Union, regarding the draft for amendment and supplement of the Healthcare Insurance Act. The draft was moved by a group of MPs from the National Movement Simeon II (NMSII). The Management Board of the union is now seeking a lobby in Parliament in order to stop the discussions and the adoption of the proposed draft.Discontent with the ideas of the group appeared right after the meeting between the doctors' union Chairman, Dr. Andrey Kehayov, and the branch organisation in Kurdzhali. The amendments to the law were also disapproved by doctors from Sofia, Plovdiv, Varna, Bourgas, Pleven, Stara Zagora, etc. Doctors are protesting against a proposal of yellow MPs who want the major set of medical activities, included in the future national frame agreement, to be defined by a decree of the Healthcare Minister. Until now, this set has been directly negotiated by the Bulgarian Doctors Union and the National Healthcare Insurance Fund (NHIF).The change will allow prices of medical services to be determined according to the money available in the healthcare fund at the specific moment, and then the real value of the activities will be ignored, said Dr. Atanas Kundurdzhiev. We know that the NHIF is planning to pay less than these activities really cost. That's why, if the amendment is approved in plenary hall, we are not going to sign the 2003 National Frame Agreement. Dr. Andrey Kehayov in turn said the administrative determination of medical services by the Healthcare Minister will stop investments in hospitals, diagnostic centres and laboratories. Their managers will not take the risk to pay for new equipment while they are unable to settle their own revenues in harmony with the real prices.Healthcare in Bulgaria is threatened by a crisis similar to the one from 1996-1997, the doctors' union warned. The 2003 national frame agreement should be signed by the union and the NHIF according to the amendments to the Healthcare Insurance Act. However, amendments are planned to be made to 103 of its paragraphs, which means that the MPs will manage to vote the document on second reading no sooner than end-November. Then the NHIF will hold a new general meeting and form a new management board, and will invite a competition for a director of the fund. The competition should be held within three months following its announcement. It means that by next April hospitals will have at their disposal BGN100MN instead of BGN200MN from the fund. The money will be distributed among 40 and not 70 clinical paths as stipulated by the fund's 2003 draft budget, doctors from the union underline. The restriction is required by a text in the Law on Health Insurance which stipulates that if the new national frame agreement fails to be signed by January 1 of the following year, the agreement for the previous year remains valid.In the meantime, the Union of Healthcare Employers forecasts that hospitals will enter the new year with nearly BGN60MN debts because of unpaid bills to medical and electricity suppliers.

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