Romania plans to switch from a state insurance healthcare system to a private one

BMJ 2011; 343 doi: (Published 24 November 2011) Cite this as: BMJ 2011;343:d7611
  1. Nicoleta Bunduc
  1. 1Iasi

Radical changes are being introduced into the Romanian healthcare system, transforming it from a state based health insurance scheme to one based on private insurance companies.

Under the proposals the National Health Insurance House, which runs the healthcare system, will be turned into a supervisory body which regulates private companies.

At present Romanians pay 5.5% of their income into a state insurance system, and their employers pay in 5.2%. The National Health Insurance House then distributes the money on a regional basis. When patients seek hospital care, they sometimes find that the hospitals have run out of funds, and they have to pay fees for some of their treatment.

The reforms will be put before the Romanian parliament in the next two weeks, and the details of what package the health insurance companies will provide will be hammered out in the second half of December. If approved, the changes will be made in 2013 at the earliest.

Two tiers of cover will exist under the new system—a basic health services package, which will be provided by all private insurance companies, and a supplementary charge for additional services.

Ioana Bianchi, adviser to the president of the National Health Insurance House, said that experts from the World Bank would be proposing a list of the services that will not be paid for by the state. “These services will continue to be available, but patients will only be able get them by paying a supplementary health insurance,” she said.

The plans also include turning hospitals into commercial societies or foundations with insurance companies commissioning their services.

Dr Bianchi said, “The purpose of these reforms is to improve the economic efficiency of the health sector as well as guaranteeing access to health care.”

Dumitru Costin, the president of the National Trade Union Block, criticised the proposals on 17 October during a debate on the social and human rights.

“If the so-called health reforms are approved and the National Health Insurance House is dissolved there will be 15 million people in Romania without access to medical services,” he said. This is because at the moment only about five million out of Romania’s 20 million population pay towards health costs out of their income.


Cite this as: BMJ 2011;343:d7611