According to Eurostat data, Romania ranks last in the European Union in terms of the money allocated for the health care of the population. Specifically, in the year 2022, while the average expenditure per capita at the European level was 3,600 euros, only 858 euros were allocated in Romania. And the situation is just as bad when it comes to the percentage of GDP allocated to this field.
The lack of money is burying Romanian health. Source: archive
Prof. university Dr. Dorel Săndesc, manager of the Emergency County Clinical Hospital in Timisoara, told “Adevărul” that we are witnessing a real paradox: “We have modernized hospitals, many of them have invested in state-of-the-art equipment, but, on the other hand, medical services are underfunded”.
The highest expenditure on health was reported in Luxembourg where two years ago 6,590 euros were allocated per inhabitant. Next comes Denmark, a country that allocated 6,110 euros and Ireland with 5,998 euros. At the opposite pole is Poland, which spent 1,137 euros per inhabitant on the health of its citizens, Bulgaria, with a capital of only 990 euros, and Romania with 858 euros.
But, making a comparison with the situation in 2014, health expenses have increased in all EU states, including Romania. Specifically, the highest percentage increases were recorded in Latvia (140.5%), Lithuania (125.6%) and Romania (123.1%), Eurostat data also show.
As for the percentage of GDP allocated to health, at the level of the European Union it stood at 10.4%. The highest shares were reported in Germany (12.6% of GDP), France (11.9%) and Austria (11.2%). At the opposite pole, the lowest shares were recorded in Luxembourg (5.6% of GDP), Romania (5.8%) and Ireland (6.1%).
Compared to 2014, only six EU member states had a lower share of health care expenditure in GDP in 2022. The biggest decreases were recorded in Ireland (decrease of 3.4 percentage points), Denmark (decrease of 0.8 percentage points) and the Netherlands (decrease of 0.5 percentage points). In the case of Romania, the share of health care expenses in GDP increased from 5% in 2014 to 5.8% in 2022.
Dorel Săndesc: “We are facing a paradox”
“Unfortunately, we are not surprised. Since it entered the European Union, Romania is constantly in the last place in terms of the percentage of GDP allocated to health. Implicitly, the amounts of money that citizens benefit from for medical care are also very small”, explained prof. Dr. Dorel I understand the serious situation in which we find ourselves.
“When we, those who work in the system, say that we have difficulties, problems with financing, the following answer comes quickly: there is money, but it is not used properly. Admittedly, the proper use of available funds can be significantly improved, but even so, we cannot hide the other painful truth, which is that we have the lowest funding in the European Union.” continued the doctor.
He stated that Romania is facing a great paradox. “In the last three years, at least, only those who don’t want to see the extraordinary investments in health infrastructure. Finally, hospitals are being built, in parallel, the existing ones are being modernized, major programs have been accessed for equipping the most sanitary structures. They are welcome and historic. On the other hand, however, if this absolutely necessary development is not followed by adequate funding, we will only exacerbate the health crisis. Paradoxically, modernization will accentuate the crisis. Because you cannot ensure the functioning of modernized hospitals if you do not change the way services are financed”, explains the specialist.
Radu Gănescu, patient representative: “The system needs a fundamental restructuring”
Radu Gănescu, the president of the Coalition of Organizations of Patients with Chronic Diseases in Romania (COPAC) told “Adevărul” that we need a reform of the system. “I’m going to tell you three things that I think are very important: first, the money that is collected from the health insurance payment cannot cover health insurance for 15 million citizens. We are 5.6 million contributors. Therefore, there is not a sufficient budget to cover health services for all Romanians”, explained the patient.
The second thing that Radu Gănescu refers to is the administrative restructuring of hospitals. Radu Gănescu proposes that hospitals that do not produce be closed, and the money allocated to them be redistributed to large medical units, which attract a large number of patients. “In terms of the number of inhabitants, we have the most hospitals in the whole of Europe. Which, unfortunately, many of them don’t even have the necessary human resources, let alone funding. But they are open and consume from the same budget that large hospitals benefit from. We are talking about an inefficient system. Funds should be distributed differently.”
The third thing, says Radu Gănescu, is the fact that in Romania there are hospitals that belong to the Ministry of Health and hospitals that are subordinate to the local authorities. “We are in a situation where no one is responsible for what happens in the units administered by the county councils or town halls. It’s like they belong to nobody. They consume money, but they are held rather so that someone can say which hospital in a certain region. They should be restructured, and attention should be directed to the regional, large centers, which will need adequate funding”.
A life-saving solution: state hospitals should also operate privately
Doctor Dorel Săndesc believes that a greater freedom of decision offered to hospital managers could represent a first step towards getting out of the crisis and towards normalizing the situation. “The public hospital should provide, in addition to the services it already offers, additional services at the patient’s request. I’ll give you an example: let’s say a patient is scheduled for surgery, but wants to rush this procedure. He would only have to request this from the state hospital, instead of using private medical services. The patient would pay lower rates and be assured that they are in good hands. But I am not saying that private doctors are not professionals. I’m just saying that if something goes wrong there, the patient is sent to us, in the public system. If this measure, absolutely simple, absolutely justified, will be implemented, it will give the opportunity to managers who have the initiative to develop the hospital. The advantages would be extraordinary”.
Patients, on the other hand, could benefit from these services, including through private health insurance. “And the financial benefits that will return to the hospital will be used for hospitalized patients, for people who cannot afford to use private services. These earnings will not go into the dividends of an owner, a faceless property fund, but will go to our fellow citizens in need. And I think this is of major importance and the Romanian state must approve these changes“, also declared the doctor Dorel Săndesc.
Thus, the public-private duality will work naturally. “Doctors employed in the public hospital they will be able to carry out their private activity also in the public hospital and thus this problem of patient drainages from one side to the other will be solved”, he concluded the doctor.
