The Deputy Chairman of the Bulgarian Medical Union, Dr. Nikolay Brunzalov, commented on the topic of the user fee for visits to a doctor's office. According to him, his statements were misunderstood: “I have never spoken about abolishing the user fee. I have said that it has been so devalued and frozen for 15 years that it has lost all meaning“.
According to Dr. Brunzalov, the current amounts - 2.90 leva for employees and 1 leva for pensioners - do not fulfill the original purpose of the fee. “It should have two functions - to supplement medical facilities and limit the overconsumption of medical services. In its current form, it does not fulfill any of them. Imagine a doctor who works with a patient, prescribes him medicine and in the end receives one leva - it's like playing on the sidewalk for small coins,“ he said.
Euro and small coins in the offices - an absurd situation
In connection with the upcoming introduction of the euro, Brunzalov warned of the purely practical problems: “Imagine - the fee is 51 euro cents. The patient gives 20 leva, and the doctor has to return the change in euros and euro cents. Is this the point of the medical profession - to deal with greengrocer's bills?“
The solution - binding to the minimum wage
As a possible solution, he suggested a return to the original idea of the fee being a percentage of the minimum wage. “It should be 1% – if the minimum wage is 960 leva, that makes about 9.60. This way, the amount will be updated automatically and will not be humiliating for the work of doctors. We are ready for talks so that the mistakes of the past are not repeated, when it was fixed in leva“, emphasized Dr. Brunzalov.
He recalled that a significant part of the population is exempt from the fee – children, people with chronic diseases, disabilities and social criteria. “This is a social activity, but it is at the expense of the work of doctors. Even on the doors of the offices there are lists that no one reads, and in the digital age this is absurd“, added Brunzalov.
Financing and deficit in the health fund
According to him, the problem with the user fee is intertwined with the general shortage of funds. “We have a 400 million leva deficit in the Health Fund as early as August. This means that there will be no increase in the salaries of doctors in hospitals. Limiting through limits is also not a solution – patients cannot wait in line because the limit has been exhausted“, he said.
As the most effective measure, Dr. Brunzalov pointed to the active participation of patients in control: “We want patient control. When the patient confirms a performed medical activity – examination, examination, prescription – then the system will become more transparent. This is a prevention against the draining of the Health Fund“. According to him, the resistance to the measure comes paradoxically even from patient organizations, but doctors insist on its introduction.
“I am not in favor of abolishing the consumer tax. I am in favor of its rationalization and return to its original functions - financing and limiting overconsumption. We want dialogue and a rational solution, and not for the offices to turn into cash registers for small coins“, concluded Dr. Brunzalov.