The state of Bulgaria’s health system remains problematic

Written by on November 24, 2017 in Bulgaria - Comments Off on The state of Bulgaria’s health system remains problematic

The European Commission released its ‘State of Health in the EU’ report, which includes Health Country Profiles for all 28 member states of the European Union. Those documents provide an in-depth analysis of the health systems, or the “health of health”, so to speak.

These profiles, including the one for Bulgaria, include a glance at the health of the population, risk factors and the effectiveness of the different health systems in the EU.

“Spending only 3% of our health budgets on prevention, compared with 80% on the treatment of diseases, is simply not enough”, Vytenis Andriukaitis, the EU’s Commissioner for Health and Food Safety, said.

“We need better access to primary care so that the emergency room isn’t people’s first port of call. And we need to enshrine health promotion and disease prevention into all policy sectors to improve people’s health and reduce pressure on health systems”, Andriukaitis stated.

He said, by offering comprehensive data in its report, the EU aimed to support national health authorities “in tackling the challenges and in making the right policy and investment choices”. The Commissioner said “I hope they will make good use of it.”

The State of Health in the EU report is also supposed to reveal potential areas where the Commission can encourage mutual learning and an exchange of good practices between the member states. Copied ideas are sometimes the best ones, especially in an area as important as health.

What the state of health Bulgaria is concerned, things are not looking too good. According to the report, “the health status of people in Bulgaria has improved more slowly than in other EU countries.”

In blunt terms, Bulgaria’s health system is in a terrible state. Of course, the EU chose a much more diplomatic wording. This is what it sounds like: “Challenges in terms of access and quality remain substantial.”

In the Health Country Profiles for the country, it says the smoking rates were the highest in the European Union. While levels of binge drinking (as a measure for excessive alcohol consumption), were lower than in other EU countries, the overall per capita alcohol consumption was the fifth highest.

Prevalence of obesity is low in Bulgaria, which is good. On the other hand, it is rising quickly, in particular among male adolescents. Legislative efforts to mitigate risk factors have yet not been effective, to the opinion of the European Commission.

Life expectancy in Bulgaria has increased, compared to the last reports, but remains below the EU average.

Yet another issue in Bulgaria is the health spending. In 2015, Bulgaria spent 1117 Euro per head on health care, less than half the EU average, which was 2797 Euro. The report also says roughly half of total health expenditure was publicly financed and “Bulgaria has exceptionally high out-of-pocket payments – 48% – the highest in the EU.”

The following is an additional issue: A total of 12 percent of all Bulgarians lack health insurance coverage. The Health Country Profile reads: “The revenue base for the Social Health Insurance remains narrow due to low incomes, many uninsured individuals and a large informal sector.”

What access to health care in Bulgaria is concerned, the report says the following: “Travel distance and availability of doctors remain important barriers, especially for lower income groups.” This means health care in this country partially depends of the patient’s wallet size.

The entire Health Country Profile for Bulgaria, by the European Commission, can be accessed here.

All photos show Sofia’s Pirogov Hospital. Photos by Imanuel Marcus.







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