In healthcare money is never enough anywhere, even in the richest countries, stated the manager of the NHIF Dr. Rumyana Todorova in response to the question whether she was pleased with the NHIF budget for 2015. “But if we concentrate, we should say ‘yes’”, – she indicated and pointed out once again that the sum is by BGN 252 million more than the originally adopted by the Parliament budget for 2014

„In my view, the money would not be enough“,- she said just the same and explained: „Relative tranquility will be brought into the system, but there are certain objective laws in healthcare, which, no matter what the budget is, no matter how well calculated it is, cannot be covered 100%.” Dr. Todorova noted that there is a continuous increase in the number of patients and once again noted that the annual average number of cancer patients increases by about 9000, which means nearly BGN 70 million to the NHIF. “Of course, this is related to the constantly improving diagnosis and new technologies. On the other hand, the access to better medicines prolongs life and enhances the credibility of the institution and the resorting of patients to the mandatory health insurance increases, “- she said.

According to the manager of the NHIF there will be a change, but it can not happen all of a sudden. “For me 2015 will be a buffer year, during which we will work on legislative changes and at the same time we will use all the opportunities for the control and correct targeting of cash flows, while these reforms are taking place,” she said, adding that according to her a year is absolutely sufficient to lay the foundation for the changes.

Dr. Todorova said that the medical referrals will not become inapplicable in 2015 and that they are a form of control in outpatient care. “On the other hand there is a proposal by the BMA for them to participate in the methodology for the allocation of funds to hospitals and to participate actively in the control. There is even a proposal by them for 90% of the resources which were actually paid the Health Fund in 2014 to be distributed for 2015,” – she informed.

Regarding the problem with the drug costs the NHIF manager commented: “Drugs are in the hands of the physician and logically it has to be so. The doctor is the one who will choose which medication to use, what is the most suitable thing for the patient. No financial institution can say that. Perhaps this is the place where the insurance institutions should become operative. I.e. there should be an additional resource, because with this resource the Fund cannot cover everything.” She brought up the medicines for rare diseases as well, which were transferred to the NHIF in 2011. At that time the Fund paid for them BGN 24 million, while now the amount is BGN 69 million, reported Dr. Todorova.

And, once again the manager of the NHIF brought up the slashed control capacity of the Fund regarding the money that has been spent by it. She indicated that the financial penalties, which the institution can impose if irregularities are detected, range between BGN 200 and 500, and asked: “Should not the sanctions in the “Control” department be more serious? Should they only be in cash? Should we focus on terminating the contract with the establishment, if it has not performed the action? ”

The state has to warm to its role, summed up Dr. Rumyana Todorova and clarified: “As well as to pay its health insurance contributions as much as we pay and to warm to its role of a regulator and guardian of this system.”