Health Financing System in Bulgaria

This monograph focuses on theoretical concepts and practically applied assessments of the development of the healthcare financial system and its reform over the last 30 years – one of the most important topics in the field of the healthcare economy. It is the result of eighteen years of scientific and expert work. The monograph Health Financing System in Bulgaria by Antoniya Dimova is a remarkably extensive theoretical and systematic study of the financing of the healthcare system that contributes to the development of Bulgarian healthcare economics. Antoniya Dimova is a representative of the strong Varna scientific movement of members of the Health Economics and Management Department, with excellent training and international experience. Within its structure, the monograph encompasses an introduction, four chapters, a conclusion and a reference list of around 180 sources, most of which are written in English. The advantage of this monograph is that different illustrative tools are used – figures, charts and tables. The first chapter presents the main theoretical concepts and aspects of healthcare financing – accumulation of funds, pooling them into a common fund, funds distribution by types of activities, levels and structures, and purchase and provision of health services. The second chapter is devoted to the historical development of the health financing system in Bulgaria since its genesis in 1906, with the introduction of the first form of social health insurance. Applying the historical approach, Antoniya Dimova defines different stages in the development of the system. The third chapter presents the main players in the financing system – the NHIF, Ministry of Health, professional organizations and consumers contributing with regulated and unregulated payments. The most interesting parts, with the assessments and suggestions of the author, are the fourth chapter and conclusions, focused on diagnosing the problems of the health financing system and addressing possible approaches for solutions. The author compares the two most important issues of health system financing in Bulgaria – resource deficiency and inefficient use of these resources.