The low-down on the situation regarding regulatory reforms in Bulgaria. Prepared in association with Kinstellar, a leading law firm in Bulgaria, this is an extract from The Pharma Legal Handbook: Bulgaria, available to purchase here for USD 99.
1. Are there proposals for reform or significant change to the healthcare system?
The topic of changing the existing healthcare system has been thoroughly debated in Bulgaria. In the final quarter of 2018, the Bulgarian minister of healthcare proposed two alternative models (“Model A” and “Model B”) to fight the inefficiencies of the current system. Both models entail the apportion of a more significant role to private health insurers.
Model A essentially envisages the de-monopolization of the National Health Insurance Fund (the “NHIF”) and immediate competition between private health insurers. It is meant to enable insured individuals to choose between insurers for the purposes of the mandatory health security. The NHIF would, however, continue its operation in competition with the private actors. Model A further entails that insured persons could transfer the payment of their premiums directly to the new health insurance provider of their choice. In case of insolvency, the NHIF or another fund would step in to cover the servicing of the insured persons.
Model B envisages that the solidarity model currently in place in Bulgaria would be transformed into a more personalized health security model. The NHIF would be gradually demonopolized. Model B would essentially be comprised of three pillars: (i) mandatory health security (8%); (ii) mandatory additional health security with a fixed premium amounting to a small sum; and (iii) voluntary health security. In this case, the NHIF would cover the treatment fees to a certain threshold, and the rest would be covered by the patient.
2. When are they likely to come into force?
There is certain scepticism in Bulgaria about the prospects of the healthcare system changing in the near future. However, the goal is for the new system to be introduced by the end of 2019 or in 2020.