Health Legislation. Basic Acts Governing the Health Care System
Health legislation = legal rules regulating healthcare, medical professions, patient rights, financing, and medical institutions.
Legal Norm
- obligatory for everyone
- violation – punishment/sanctions
- regulates important social relations
Characteristics:
created by the state – mandatory – written/public applies equally to everyone – enforced by coercion
Structure of Legal Norm
Hypothesis
- hypothetical situation – when the rule applies
Disposition
- required behavior – rights + obligations
Sanction
- punishment for violation
- fines – dismissal – imprisonment
Moral Norm vs Legal Norm
- Moral norm:
- socially accepted behavior
- violation – frowned upon
- Legal norm:
- state-enforced
- mandatory – legal punishment possible
Responsibilities
administrative
- licenses – documents
disciplinary
- warning – firing
civil
- compensation/damages
criminal
- malpractice – bodily harm
Hierarchy of Legislation in Bulgaria
- Constitution
- Constitutional Court decisions
- International/EU law
- Laws/Acts
- Council of Ministers regulations
- Ministry + municipal regulations
All laws must comply with the Constitution.
Main Courts
- Supreme Judicial Council
- Supreme Administrative Court
- Supreme Court of Cassation
Constitutional Court
- district – county – administrative – military courts
- Dental/medical examples:
- obtaining informed consent before treatment
- maintaining sterilization/ infection control
- keeping patient confidentiality
- having a valid dental license
- Example:
- Hypothesis
- patient requires dental treatment
- Disposition
- dentist must obtain informed consent + follow professional standards
- Sanction
- disciplinary action, fine, or legal liability if violated
- Examples in dentistry:
- needing a license to practice obtaining informed consent following infection control protocols not treating outside your specialty
Health Act preserving patient’s current health status improving quality/effectiveness of medical care priority groups: children – (check-ups, fluoridation, education), pregnant women
vulnerable groups: orphans, immunocompromised patients elderly patients: chronic disease, tooth/bone/tissue loss
health promotion = public education + health information prevention = early diagnosis + disease reversal if possible focuses on equal access + high-quality healthcare
Includes:
- healthcare services – mental health – medical education medical rights/obligations – medical science
Medical Treatment Facilities Act differentiates facilities by funding: public vs private regulates structure + activity of medical institutions
Outpatient care
- patient enters + leaves same day
- dental practice – medical center – medico-dental center medico-dental centers = work with multiple specialists diagnostic centers – laboratories
Inpatient care
- overnight hospitalization
- active treatment = hospital – treatment – discharge home prolonged treatment = chronic disease management
- rehabilitation hospitals
- university hospitals = treatment + teaching/training
Levels of healthcare
- primary healthcare = GP/first contact before diagnosis
- specialized healthcare = specialist physician/dentist
Requirements
- outpatient facilities registered with RHI
- inpatient facilities require Ministry certificate