Nicușor Dan, freshly elected as president, comes with an ambitious program to reform the health system. His promises are focused on digitalization, efficiency of long -term strategic processes and investments. Among the key initiatives: introduction of a unique electronic medical file for each patient, online programming in the public system and extending the telemedicine network.
Worried doctor. Freepick.com source
In addition, the president announces significant changes in the way CNAS settle the services, in the idea of balance between outpatient and hospital, but also a national health investment strategy for a decade, elaborated with the support of the private sector.
The pressure system: a “gigantic cost center” in an austerity budget
When the budget is gathered, and the austerity becomes a norm, any ambitious health plan raises an essential question: where do money? In an underfilled, fragile and burdened system, can Romania support digitalization, smart hospitals and a modern medical network?
Dr. Sorin Paveliu, an expert in health policies, warns that “Romania is in a period of inevitable austerity, in which SŢănity is a gigantic cost center, and The Prime Minister, the Minister of Finance and the Minister of Health must keep an eye on each leu. ”
Sorin Paveliu: Health investments are made from PNRR
“There are huge costs with medicines, with hospitals – whether public or financed from PNRR – but also with the private sector, which needs money from the state to work. If there is no strict control, we risk the entire system to collapse under the weight of their own expensesI ”, Paveliu draws attention.
The expert in health policies, Dr. Sorin Paveliu, also emphasizes that Nicușor Dan’s plans come in a dramatic budget context: “The CNAS budget comes with a deficit of 20%. In 6 months, this deficit will put a huge pressure on the government. We are in the face of a period of austerity and we must recognize that health can become a threat to financial stability. ”
According to him, if we remove the pensions, defense and interest in the public debt, health comes to consume about 25% of what remains, which makes it almost impossible to implement ambitious reforms without a major political reconfiguration:
“If an epidemiological seizure appears or the system employment does not stop, we will not have to support these plans. The investments are based almost exclusively on the PNRR, and if we do not keep up with the deadlines and settlements, we risk losing this money.. ”
Under the pressure of drugs and private sector
Another vulnerability reported by Paveliu is related to the costs of innovative drugs, which occupy a “gigantic slice ” From the budget, against the background of pressures from pharmaceutical companies and the private medical services industry: “There is a real pressure for the public system to finance massively private providers, but in a budget of austerity it means less money for public hospitals, prevention or salaries.”
The expert proposes that the health budget will be permanently monitored by a delegate from the Ministry of Finance, and CNAS will be reformed in depth, not only administrative, but also in the way they assume the payment commitments.
“A hospital costs on average 50 million euros per year. If we look at the three hospitals in the PNRR – with one and a half billion allocated – there is a real risk that, due to bureaucracy and inability to respect the deadlines, we will lose this money.”, Says the expert.
PNRR: Investments in danger, restricted goals
Only 13 hospitals are currently under discussion for financing through the National Plan of Redress and Resility (PNRR), according to Minister Marcel Boloș. Another six will be built through a loan from the European Investment Bank. But the absorption of European funds is slow, and the danger of losing money – because of the delays – is as real as possible.
This repositioning comes in a moment of institutional fragility and budget pressure, in which each investment must be carefully prioritized.
Doctors ask for a country project where health is a national priority
Doctors in Romania want more than fragmented reforms or electoral promises. They ask for a country project in which health is recognized as a true national priority, not just a secondary theme on the political agenda. It is the call launched by the president of the Romanian College of Physicians (CMR), prof. dr. Cătălina Poiană, who draws attention “athe need for health repositioning in the center of public decisions ”.
“In the last year, we have crossed numerous electoral cycles-MEPs, parliamentary, presidential. A period when many things have entered a certain ‘conservation state’, and the focus and public agenda have primarily concerned these elections.”said Dr. Cătălina Poiană.
Ambitious reform but without a clear source of financing
The electoral program in terms of health of President Nicușor Dan is ambitious, but he risks being suffocated by the severe economic context in which he was launched, I think experts. Romania registered in 2024 the largest budget deficit in the European Union-9.3% of GDP-and the worst fiscal imbalance in the 2009 crisis. Although the Government has assumed the deficit to 7% this year, the current data shows an economic stagnation, and the deficit remains high.
Until June 4, Romania must present to the European Commission a credible fiscal correction plan. Otherwise, the procedure for suspending European funds, including those in the PNR, becomes extremely probable. European sources say that the political agreement for suspension already exists – it only remains to see the moment when it will be implemented.
In this context, health reforms have real chances only if the Government, the Ministry of Finance and the health work together, with their eyes on each leu and on each contract. Otherwise, we risk transforming the electronic file and smart hospitals into simple digital promises into a sick system of chronic subfiliation.
