Bulgaria is culturally diverse and geographically unique. The Balkan nation borders the Black Sea and has Greek, Slavic, Ottoman and Persian influences. Still suffering from the effects of the 2008 financial crisis; however, Bulgaria is the most impoverished country in the European Union based on GDP per capita. The Eastern European country has seen both success and shortcomings in attempting to address healthcare outcomes. Here are four facts about healthcare in Bulgaria.
4 Facts About Healthcare in Bulgaria
- Spending on healthcare in Bulgaria is low. In 2018, the Bulgarian healthcare budget was approximately $2.2 billion, or 4.3% of the Bulgarian GDP. As one of the lowest spenders in Europe, the system in Bulgaria relies on out-of-pocket payments. This is problematic because it limits access to healthcare, particularly for those living in poverty. Moreover, external development is not helping solve the problem. Such sources provide only one percent of the total health funds in Bulgaria.
- There have been gradual improvements in healthcare outcomes. Despite low spending levels, healthcare outcomes in Bulgaria have been progressively improving. Life expectancy in Bulgaria has been increasing throughout the past four decades. Between 2000 and 2015, the Bulgarian life expectancy increased by 3.1 years. The death rate for circulatory system diseases has also declined since 2000, following its peak in the 1990s. While Bulgaria has been making progress in these areas, the most significant is related to infant mortality rates. In 2000, the infant mortality rate was 13.3 per 1,000 live births, but the rate decreased to 6.6 in 2015. The neonatal mortality rate also decreased, roughly halving between 1980 to 2015.
- Healthcare in Bulgaria is financed by both public and private sources. In order to generate funds, Bulgaria employs a mixed-finance system. While the government covers some portions of healthcare, private sources finance many procedures. There is a rough balance, with 57.8% of total health expenditures from public finances and 42.2% from private sources. The percent of private expenditures, however, is increasing at a faster rate than public expenditures. On the public side, the most significant health service purchase is the National Health Insurance Fund (NHIF). While citizens are free to purchase additional insurance packages, “less than 3% of the population purchased some form of voluntary health insurance in 2020.”
- Healthcare in Bulgaria is undermined by a dwindling healthcare workforce. The overwhelming impact of the COVID-19 pandemic has illuminated one of the most significant struggles of healthcare in Bulgaria: there simply aren’t enough healthcare workers. While Bulgaria has received substantial investment from international organizations like the European Union to upgrade medical infrastructure, these funds do little to ensure Bulgaria has a thriving healthcare workforce. At present, thousands of Bulgarian healthcare workers are finding better-paying jobs in Western Europe. Kristina Macneva, an emergency doctor that has stayed in Bulgaria, explains that “the main problem is the lack of medical staff” and that they are in “dire need.”
Though great strides have been made in healthcare in Bulgaria, more work still needs to be done to ensure all citizens are receiving quality care. Moving forward, it is essential that the government devotes more resources to healthcare in the nation.
– Kendall Carll