Romania has a high incidence of devastating health care costs compared to other European Union (EU) countries, according to a new WHO/Europe report. In 2015, reports revealed that one of her households in eight had out-of-pocket payments that were more than 40% of his ability to pay for medical bills. Devastating healthcare spending means households can no longer afford other basic needs such as food, housing and electricity.
A report produced by the WHO Barcelona Office for Health Systems Financing is the first comprehensive analysis of economic protection (also known as access to affordable healthcare) in Romania. Analysis shows that devastating health care costs are concentrated in his poorest 40% of households and the elderly. This is primarily due to out-of-pocket costs for outpatient medications, followed by dental and outpatient care.
Between 2010 and 2015, the incidence of catastrophic health care costs increased, especially among poor households. Although access to health care has improved over this period, the proportion of unmet need for health care and dental care in Romania remains well above the EU average.
Coverage gap
Reforms introduced in the last few years have expanded the range of health benefits provided by the Romanian National Health Institute (NHIH) and increased the level of public spending on health.
Despite these positive developments, the report also draws attention to persistent gaps in health insurance coverage.
- Twelve percent of the population is uninsured and has access to only some publicly funded health services. To receive NHIH benefits, you must pay health insurance premiums, which some people with low incomes cannot afford.
- Prescription drug fee waivers (co-payments) are not intended for low-income individuals and have no cap on co-payments. Balancing and supplemental claims by healthcare providers are also problematic and compromise transparency.
- Access to dental care is limited due to budget constraints.
Other factors that contribute to financial hardship and unmet needs include:
- Informal payments to health care workers and payments for medicines and supplies, especially in hospital care.
- Problems with public hospital service quality and aging infrastructure.When
- Lack of medical facilities and specialists in rural areas.
Make healthcare affordable for everyone
A new report presents a set of policy recommendations to improve access and economic protection in Romania. These include the need to:
- Ensuring that the entire population is covered by NHIH and has access to the same set of benefits.
- Extend copay waivers to low-income households and introduce income-based caps on all copayments.
- Restrict the ability of healthcare providers to charge people additional user fees through balance billing and top-up billing.
- Continue to improve the way NHIH purchases medicines, including over-the-counter medicines.
- Strengthen dental care coverage and purchases to meet the high unmet needs of the poorest households.
- Address informal payments, starting with better oversight.When
- We will support these changes by increasing public investment in health systems. Romania’s public spending on health is still low compared to most EU countries, at her 4.6% of GDP in 2019 compared to her 6% in the EU average.
WHO is helping countries transition to universal health coverage
Economic protection is central to universal health coverage at the heart of the WHO/European strategic framework, the European Work Programme. Through the WHO Barcelona Health Systems Financing Office, WHO/Europe monitors financial protection in over 40 countries.
Economic protection is an indicator of the Sustainable Development Goals and part of the European Social Rights pillar. The WHO Barcelona office provides tailored technical assistance to countries to reduce unmet needs and economic hardships by identifying and addressing coverage gaps.
