December 1, 2009



MPs, representatives of institutions, trade unions, NGOs and private insurance funds debated at a round table in parliament on a strategy to reform health insurance. The forum, held on December 1, 2009 was organized by the Chair of the Parliamentary Committee on Health, Dr Lachezar Ivanov and under the patronage of Prime Minister Boyko Borisov.


At the opening, Dr. Lachezar Ivanov stressed that the implementation of the health care reform depends on three main factors –political will , unity around the idea for reforms as well as financial resources. He presented a strategy for reform in the field of health insurance, based on a three-pillar model of security - basic mandatory , complementary mandatory and a voluntary package. According to Dr. Lachezar Ivanov the reform foresees that private insurance funds will manage the public finances, collected for health insurance from the mandatory and the complementary mandatory package, and will be obliged to secure equal access to medical care to any person regardless of age and health status,. He added that the commitment of the state will be to set the ceiling for the prices of medical services and activities and the scope of the services provided by the mandatory health insurance as well as to regulate the private health insurance companies.


The strategy provides the insurance companies to make a profit from the second pillar i.e. the complementary mandatory insurance. In the first two years of obtaining a license, the company will be obliged to reinvest the profit in order to introduce modern information systems and technology, create its branch network and promote the staff education, pointed out Dr Lachezar Ivanov. He added that the health insurance companies will be subject to a separate supervision, from the one exercised over the other companies of the insurance industry
In response to a question from a participant in the discussion, the Chairman of the Parliamentary Committee on Health explained that the plan is to create an Executive Agency at the Ministry of Finance, which to make an overview and financial analysis, forecasts and updates of all the health services and their cost. He added that the proposal for the creation of this agency belongs to the Finance Minister Simeon Diankov.


Dr. Lachezar Ivanov said that if realized the reform would improve the quality of health services to those insured, in terms of increased competition and by giving patients the freedom to choose their health provider and would modernize and optimize the health care system. The document abolishes the monopoly of the NHIF and launches the entry of private health insurance companies. The health contributions of 4, 1 million citizens mentioned in art. 40 of the Health Insurance Act (pensioners, children, etc.) will be granted by the state, all remaining 2,5 million Bulgarians will have to submit additional personal funds for compulsory insurance in the 2nd pillar by deducting 2 per cent of their declared annual income.