Introduction
Health legislation is the set of all legal regulative documents which control the variety of healthcare system relations. This topic covers its functions and principles and the Health Insurance Act (1998): compulsory and voluntary health insurance, the National Health Insurance Fund (NHIF), the rights and obligations of the insured, and the National Framework Contract.
Health legislation in Bulgaria
- Functions: organisation and protection (of patients, hospital attendants etc.).
- Principles:
- Right to medical help
- Right to personal freedom and to taking decisions
- Respect of human dignity
- The Ministry of Health is responsible for national health policy and the overall organisation and functioning of the health system, and coordinates with all ministries with relevance to public health.
Health insurance
Health insurance is an activity related to collecting health insurance instalments and premiums, managing the collected resources and spending them for payment of health activities, services and commodities, as stipulated by this law, by the National Framework Contract and by the contracts for voluntary health insurance.
- The Health Insurance Act of 1998 reformed the Bulgarian health system into a health insurance system. Health insurance in Bulgaria is obligatory and additional voluntary.
- Compulsory HI: the collecting of resources from obligatory instalments determined by a law is carried out by the National Insurance Institute; their management and spending for health care is carried out by the National Health Insurance Fund and its territorial divisions, the regional health insurance funds (RHIF). It provides the basic package of health care activities guaranteed by the NHIF budget.
- Voluntary HI: additional, carried out by shareholder companies registered according to the Commercial Law which have obtained a licence under the conditions and by the order of this law.
- Key players: the insured individuals; the health care providers; the third-party payers, comprising the NHIF (the single payer in the social health insurance, SHI, system) and voluntary health insurance companies (VHICs).
- The insurance system covers diagnostic, treatment and rehabilitation services as well as medications for the insured individual.
Obligatory versus voluntary health insurance
Guarantee (Art. 4)
Obligatory health insurance guarantees to the insured persons accessible medical care through a definite type, range and volume of package of health activities, as well as a free choice of a provider who has concluded a contract with a regional health insurance fund. The right of choice is valid for the whole territory of the country and cannot be restricted on geographic and/or administrative grounds.
Health insurance provides
- Primary non-hospital medical care