What Would it Take to Improve the Health System in Bulgaria?

There is no recipe, but ingredients matter - according to the World Bank, at the First Annual Conference on “Innovations and Good Practices in the Health Sector” 

Nearly everyone who interacts with the health care system in Bulgaria ends up wondering: is the system underfunded? Is it organized in a way which provides the best possible quality given the resources available? Am I paying a fair price for the health services and drugs I receive?

On September 24^th, 2014 the Capital Weekly newspaper organized a conference to debate these exact questions. The one-day event titled First Annual Innovations and Good Practices in the Health Sector Conference brought together more than 100 policymakers, representatives of different health organizations, medical professionals, representatives from the pharmaceutical sector, and different patient organizations. The conference looked to highlight good practices in the health sector and suggest solutions for improving the effectiveness, accessibility, and resilience of Bulgaria’s healthcare system in the context of the National Health Strategy 2014 - 2020 and the European Commission Communication on health systems organization.

A World Bank team of experts, led by Tony Thompson, Country Manager for Bulgaria, Czech Republic, and Slovakia, also contributed to these discussions - adding one important aspect to all the questions raised by the participants, namely: how to ensure that people vulnerable to poverty do not bear an unreasonable financial burden when they access necessary health services in the country.

Agnès Couffinhal, World Bank Senior Economist and featured presenter at the conference, highlighted three key ingredients often found in countries which perform better than Bulgaria.

“Patient-based provider payments, provider autonomy, and the use of information for decision-making – these ingredients have to be organized coherently in order to ensure the accountability of service providers,” Couffinhal emphasized.

In April of this year, the Bulgarian government engaged the World Bank through the mechanisms of reimbursable analytical and advisory services for the health sector, focusing on health financing. Under the agreement, the World Bank will analyze how funding flows through the health system in the country and the extent to which this is organized in a way that contributes to achieving important goals - such as ensuring access to healthcare in an efficient and affordable way.

Two aspects of this work will be given specific attention: the hospital payment system, which is slated to undergo reform, and pharmaceutical policies. The entire work will factor in the fiscal outlook of Bulgaria to enhance long-term sustainability. Ultimately, the work will support the Government as it prioritizes the ambitious reform program laid out in the National Health Strategy 2014-2020.