Bulgaria Health Financing : Final Report on Health Financing Diagnostic and Review of Envisaged Reforms
Health financing in Bulgaria is organized in a way that should, in theory, allow the system to deliver good performance. In particular, the national health insurance fund was set up to provide universal coverage, and the provider-payment system contains elements of international best practices. The hospital-centric service delivery structure is not well targeted to the predominant and growing burden of non-communicable diseases, and loopholes in the provider-payment system reinforce this bias toward expensive hospital care. The first part of this report presents a health financing diagnostic to assist the Government of Bulgaria in developing health financing reform options that improve the efficiency, equity, and long-term sustainability of the Bulgarian health system. The second part reviews the reform agenda currently envisaged by the government with a focus on health financing aspects. It presents practical suggestions, drawn from international experience, which should support the government as it moves toward implementing its reform agenda. These suggestions aim to enhance the reforms’ capacity to address some of the performance gaps highlighted in part one with respect to efficiency, sustainability, and capacity to provide financial protection.
Summary: | Health financing in Bulgaria is
organized in a way that should, in theory, allow the system
to deliver good performance. In particular, the national
health insurance fund was set up to provide universal
coverage, and the provider-payment system contains elements
of international best practices. The hospital-centric
service delivery structure is not well targeted to the
predominant and growing burden of non-communicable diseases,
and loopholes in the provider-payment system reinforce this
bias toward expensive hospital care. The first part of this
report presents a health financing diagnostic to assist the
Government of Bulgaria in developing health financing reform
options that improve the efficiency, equity, and long-term
sustainability of the Bulgarian health system. The second
part reviews the reform agenda currently envisaged by the
government with a focus on health financing aspects. It
presents practical suggestions, drawn from international
experience, which should support the government as it moves
toward implementing its reform agenda. These suggestions aim
to enhance the reforms’ capacity to address some of the
performance gaps highlighted in part one with respect to
efficiency, sustainability, and capacity to provide
financial protection. |
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