A matter of good will

A matter of good will

A healthy system cannot function without solid investments. A phenomenon that has to be underlined in the current background of healthcare landscape in Romania is the lack of a larger infrastructure of multifunctional hospitals.

Now, in Romania, more than half of the country hospitals are sending their patients with multiple injuries or more complex illnesses to the main counties. These things are happening because only large hospitals can handle the needs of more complex cases and their number can be counted on a hand’s fingers in Romania.


I consider the measure of closing the 150 hospitals was a right one, as they were only functioning as first-aid n units. It is fair to search for a solution in order to vitalize a system.


On the other hand, let’s not forget that Romania assigns the lowest budget in Europe for the healthcare system. Just to compare: A Romanian patient benefits from an amount of 325 Euro yearly, while a patient living in a western country, is assigned several thousand Euros.  Everything in this segment depends on the political will.


The health, as a vital system in the Romanian economy is assigned the smallest share of GDP in Europe. In 2012, health sector has been budgeted with only 3.7 percent from the GDP, while in 2009, it had 5.6 percent. The European average is 9.9 percent from the countries’ GDP assigned to healthcare.


A debatable health law


The reforming of medical system is a good idea, as it is a welcoming idea to change in better what it is malfunctioning. But this should happen only under the condition of a blunt clarity.


Now, there are too many unclear statements in this law and too many changes have been applied. I fear that my only expectation to this reform is another delay as it happened before in the case of pensions, where three years were needed in order to see a final form and to be implemented. I think that a detailed yet solid law is the best solution for the healthcare system.


The major outcome of such a law is that would leave less to no space to second guesses and questionable implementation.  Otherwise, we currently end up with an unclear law, vague, with too general regulatory statements and, as practice proved it, a vague law results in vague implementations.


As we are involved in drafting the law, as major downturns, I can specify the unclear role of insurers within the medical landscape and the so-called privatization of hospitals or specific sections. Also, as a major aspect to be addressed in this law should be the reference of mutual funds.


Private vs. state


The private system will strongly depend on the new health law.  We are talking currently of a private market worth an approximate 500 million Euros and that is estimated to evolve in the next years with a double digit growth. However, on the other hand, the corporate market is declining, and the word “cannibalized” fits to the context.


The present estimations state that the spending of a patient in private clinics decreased by 10- 15 percent. Even if the number of patients increased in the last years, they spent less in the clinics.


The investments in the private system are still attractive, considering that 30 percent of Romanian that would sign a health insurance only if there is a solid infrastructure of private hospitals. We are spending a lot of time talking about how much is the state spending for the health in Romania and how much is the private medical system injecting in the field.


But I have to add that approximate half of private companies receive money from the state, for instance, dialysis companies, some laboratories.


At this moment, physicians and even academicians wish to work in the medical private system.  Hence, it is a field with large potential, able to attract and involve not only money resources but also, specialized human capital.


In Eastern European countries, the private health policies just don’t work. Following the studies, 70 percent from the citizens said they would not apply for a health insurance. Also, the negotiations regarding the market of private insurance policies worth  now near 10 million Euro has been resumed in the beginning of this year when the new  health law has been drafted.