1963-2018 - 55 years of Research for Social Change

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Back | Programme Area: Social Policy and Development (2000 - 2009)

Health Care Reform and Inequality of Access to Health Care in Bulgaria (Draft)

This paper analyses the implications for inequality of access to health care of the new organization of the health care system in Bulgaria. Bulgarian health policy after 1989 has centred on the introduction of social health insurance, in the form of a National Health Insurance Fund, and associated reform of provision at payment mechanisms at both primary and hospital levels. This paper describes the current system of health care in Bulgaria, including the interaction of compulsory and voluntary health insurance and the private health care system. It then pulls together a wide range of sources to analyse the implications of that system for inequality of access to health care at primary, secondary and hospital level by social groups and income level. The paper also examines the current operation of the private health care system, which is at present poorly documented, and identifies the reasons for rising cost of medicines to the insurance system. The paper draws upon a small number of case studies—interviews with primary doctors and hospital managers—exploring financial issues faced by the providers.

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