Romania Health Insurance System

Romania Health Insurance System

            An effective health system improves the overall health of communities.  Mainly, it defends individuals against any ailments that will adversely affect their wellbeing. An operational health system also provides medical cover to all individuals, irrespective of their economic class.  Therefore, a health cover ensures that all patients access medical services, which improves their health outcomes. However, when individuals have no access to medical insurance, they cannot receive the care they require, and if they do, the medical bills are incredibly high (Vlaˇdescu, Gabriela Scîntee, Olsavszky, Quevedo, & Sagan, 2016). The way health services are organized, including medical insurance, varies across nations. The government of Romania strives to provide medical cover for all its citizens by making it mandatory for employed and self-employed persons to contribute.

The government controls the health care sector and determines the amount to allocate to this industry. Accordingly, the Romanian health system is divided into the district and central or national levels. The central level outlines the overall objectives and principles of the country’s medical policies. Notably, the primary institutions that oversee this branch are the National Health Insurance House (NHIH) and the Ministry of Public Health (MPH) (“Romania Health Care,” 2016). The MPH focuses on the health regulations while the NHIH controls the social medical cover system independently. The government finances part of the medical expenditures through revenues from taxes. The NHIH and MPH work on behalf of the government to ensure all Romanians can access health care.

For the most part, the country pays for health insurance through income contributions. The government expects every employer and employee to contribute 5.2 % and 5.5 %, respectively, to medical care based on their payroll (“Romania Health Care,” 2016). Self-employed individuals are supposed to use 5.5% of their incomes to receive health coverage. In effect, around 5 million people support over 20 million Romanians through their contributions (“Romania Health Care,” 2016). Particularly, the beneficiaries of the system are individuals who are disabled, dependents, children, war veterans, and military personnel. People who are on maternity or sick leave also access free health services. A small minority of Romanians make compulsory payments to ensure most people can access medical services, including vulnerable populations.

Equally, the government expects all its citizens and migrants to pay social medical insurance. The amount they contribute is around 20% of the entire health budget. However, only 86% of the population is covered, leaving 5% uninsured (Vlaˇdescu et al., 2016). The uninsured cannot receive appropriate medical care as they do not pay for insurance or have not identified a general practitioner or family doctor. These people also lack the necessary residency and official documents. For uninsured Romanians, they receive basic benefits, whereby, the insurance only covers infectious ailments, life-threatening situations, and maternity-related care (Vlaˇdescu et al., 2016). Conversely, a private cover offers an individual with complementary services, including access to better hospital accommodation. The medical facility also charges co-payments for services in the minimum benefits package. However, people can only access such services subject to contributing the compulsory payment for the basic insurance package.

The fact that few people finance the medical budget implies that hospitals do not have enough medical providers. In 2013, 264 doctors were responsible for 100,000 people (“Romania Health Care & Long-Term Care Systems,” 2016). Specialized doctors were 64 for the same number of individuals. Furthermore, only 601 nurses serviced 100,000 patients (“Romania Health Care & Long-Term Care Systems,” 2016). What is more, GPs only offer a few services in the delivery of care. Furthermore, the small amount that the government allocates to healthcare contributes to staff shortages. In 2011, the government allocated a GDP of 4.99% for health care, which is below the EU’s average (Spiru, Traşcu, Turcu, & Mărzan, 2011). The state only achieves this by reducing the number of medical personnel and constraining the medical resources available.

            In Romania, the financing of medical care is progressive, although not yet comprehensive. Predominantly, the government relies on medical insurance contributions to finance health care. It also exempts some specific vulnerable people from making these payments. What that means is that Romania cannot afford to hire enough medical personnel to cater to the needs of the entire population. Overall, the health care system in Romania is highly centralized, whereby the government controls the process.

References

Romania health care & long-term care systems. (2016). The Joint Report on Health Care and Long-Term Care Systems & Fiscal Sustainability Institutional Paper, 37 (2), 213-220. Retrieved from https://ec.europa.eu/info/sites/info/files/file_import/joint-report_ro_en_2.pdf.

Spiru, L., Traşcu, R.L. Turcu, I., & Mărzan, M. (2011). Perpetual transitions in Romanian healthcare. EPMA Journal, 2 (4), 341–350.

Vlaˇdescu, C., Gabriela Scîntee, S., Olsavszky, V., Quevedo, C. H. & Sagan, A. (2016). Romania: Health system review. Health Systems in Transition,

18 (4), 1-170. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0017/317240/Hit-Romania.pdf