Financial resources for healthcare: Cost or investment?

Abstract

Introduction: Health system has a significant contribution to the well-being of a country, and in this context, the financial resources for health should be perceived as an investment. However, in order to turn the health care cost into investment, of utmost importance is the health system effectiveness. This study examines the effectiveness of the health system in Bulgaria, characterizing health care financial resources as an expense or an investment. Results and Discussion: Although since the introduction of the health insurance system costs have increased by more than 4 times per capita, health status of the population remains unsatisfactory. . The average life expectancy is around 6 years lower than the EU average, SDR is 35.5% higher than the EU average, deaths from malignant neoplasms in Bulgaria is increasing and in 2013 and 2014 for the first time outpace the average values for the EU. Infant mortality rates remained above two times higher than the average for EU the in 2014. Along with the unsatisfactory health status indicators, the financial burden for patients is increasing. The private spending increased more significantly than the public spending. In 2013, the private spending had overtaken in relative value the size of the public resource. The high percentage of direct private payments in Bulgaria (45.43%) evidences the inadequate financial protection of the Bulgarian population, which the social health insurance system provides. Therefore, in order to acquire the sense of investment with real returns in improving the health of the nation and the stabilization of the health system, the effectiveness of financial resources for health should be substantially increased.
Conclusion: The transformation of health care costs in Bulgaria into investment requires a change in the approach of their allocation between the different levels of the health system and subsystems and between different types of activities. The introduction of quality standards is the key point to improve health outcomes at the same time with adequate allocation of financial resources - a major prerequisite for enhancing the effectiveness of health care.