Why are the administrative employees of the National Health Insurance Fund / NHIF / protesting?

How will the tremors in the coalition affect the financing of health care?

I ask Dr. Alexander Simidchiev, pulmonologist, internist with many years of experience in the field of pulmonary functional diagnostics.

He is the head of a department at the Medical Institute of the Ministry of Interior.

Dr. Simidchiev is Chairman of the Board of the Association "Air and Health".

He is a Member of Parliament in the 47th National Assembly from the DB quota and Deputy Chairman of the Standing Committee on Health in Parliament.

When we looked at the NHIF budget in the parliamentary health committee, there were adjustments to some parameters in it, including staff costs and the fund's administration.

As far as possible, given the crises in the country and abroad, the maximum is being done on the issue.

We must all take part of the responsibility to go through this period with the least damage.

The NHIF, compared to many other institutions, I would not say that it is in an unfavorable financial position.

Raising the issue now, despite the budget adjustments, leads me to think that the protests in the NHIF are inspired and incorrect.

The riots at the moment will not help us get out of the crisis faster.

Of course, people have the right to protest.

However, my opinion is that the maximum is being done as much as possible.

In the presence of these tensions, I would personally ask the parliamentary committee to consider the salaries in the NHIF - how many people work there and under what load.

I will ask for a reference on the average salaries in the treasury and the evaluation of the work, in order to be more precise in my position.

In order to break the long-talked about NHIF monopoly, it must exist.

The treasury cannot be a monopolist for one simple reason - it is a financing body, like banks.

Monopolies offer services.

In the case of the health insurance fund, it is an institution that only finances certain medical activities that doctors perform according to the instructions in the National Framework Agreement.

If there are problems in the distribution of funding, this can be fixed by an act of the National Assembly, as the fund is a public institution and its manager is elected by parliament.

In many countries, where there is such an institution as the health insurance fund, they strive to provide more financial resources in one place to cover the large differences in risks between patients who have both heavier and more expensive and lighter and tolerable payment issues.

With large differences, there is no way to cover the risks in patients with different diseases.

I do not think that there will be any benefit for patients if the funds are distributed in several funds.

Administrative costs will be multiplied and scattered in the individual structures.

I agree with colleagues who want diversification, ie.

diversification of the financing model not only by the National Health Insurance Fund, but also by an insurance model in which we have an individual account and know that the money we contribute is for ourselves.

But this is a different funding mechanism and it is good to take advantage of such ways.

The tremors in the coalition at this stage threaten the changes in healthcare and their implementation.

Decisions are difficult to reach in the absence of unanimity and majority.

Negotiating with dynamic, floating majorities is a difficult and slow process and is not always in the same direction.

Even if the budget is not updated, there is a mechanism by which the activity of the previous budget, which is divided into months, can be continued constitutionally.

There is no apocalypse, but all the processes of change will be slowed down.

NHIF

health

Dr. Alexander Simidchiev