We are starting negotiations with the Bulgarian Medical Association for the prices of clinical pathways. An annex will mention all the conditions and the relationships between the contractors, the Fund and the Medical Union. There should be a balance in the prices of clinical pathways, it is not yet known whether there will be increases. I do not know of any pathway that has been reduced. This was stated by the representative of the Bulgarian Industrial Association in the Supervisory Board of the NHIF, Prof. Grigor Dimitrov, in the program “The Day Live“ on Nova News.
According to him, the sanctions for financial violations in medical institutions are mild.
'This year, the funds for hospital care are not so generous. We have about 8% growth, given that we have 146 million leva that we need to recover. Opportunities for optimization will be sought, long and difficult negotiations with the Bulgarian Health Insurance Fund are ahead. If this year, in total, for the NHIF we have an excess of 1.1 billion compared to the previous year, according to the medium-term program for the eurozone, the additional will be half as much. About 350 million is for 2027. These figures have an explanation - in 2025 there will be a record increase in salaries. With such growth, we need to think about what will happen in the coming years," commented Prof. Dimitrov.
On March 19, the budget of the National Health Insurance Fund was adopted in second reading. The budget plan amounts to 9.5 billion, with 4 billion for hospital care and 2.3 - for medicines. This item also includes the money for the government's proposal to make antiviral drugs and antibiotics for children up to 7 years of age free. This will cost the Fund's budget 20 million leva.
According to him, it will be decided in the fall whether funds from the NHIF reserve will be used - in the amount of about 270 million leva.
"Last year, about 80% of them went for hospital care. In 2016, hospital care expenses were 1.8 billion leva, and we ended 2024 with 3.8 billion - almost a double increase. During this period, our population has decreased by about a million. It is also becoming sicker. The current NHIF expenditure for 10 years is 1 billion, 24 billion has been allocated for hospital care, 14 billion for medicines, and about 5.5 billion leva is for oncology medications alone. This year alone, 1.1 billion are the funds for the same medicines.
In recent years, thanks to the growth in pensions and salaries, the health insurance contribution has also increased. We need to find a way to optimize costs, and at the same time improve the quality of the health service," Dimitrov believes.
Regarding the pension reform, Prof. Dimitrov said that it is proposed for 2026 – 2027 that the pension contribution be increased by 3%. Over the years, mainly for political reasons, the basic principles of the pension system have been violated. The pension depends on everyone's contribution. We gave everyone the Covid supplement and the model was violated. Everyone has their share in the development of the system. But in recent years, politicians have used the system for their own purposes. This must stop. The pension insurance system is not interesting for pensioners, but for the young. If we can inspire them with confidence and certainty to make contributions to this system, the situation will improve. By 2070, the analysis showed that there will be a deficit in the system and the state will participate with funds from the budget to cover pension costs, explained Prof. Grigor Dimitrov.