• A call for reason and action to prevent the next Covid-19-like crises at the international level, to prevent crises related to the lack of human resources, insufficient allocation of funds and investments in health.

The COVID-19 pandemic has proven to be the most important factor that has disrupted health systems in recent decades.

• It has highlighted the vulnerabilities and challenges within countries’ emergency preparedness strategies and their capacity to provide healthcare services to their populations.
• In response to the strong effects of the pandemic – as well as other recent crises, such as cost-of-living pressures and the impact of conflict – countries are implementing policies to mitigate the ongoing impact on service delivery, invest in health system recovery and resilience, improve critical areas of the health sector and increase their preparedness for future shocks, an OECD report shows.
• More than one in ten Romanians do not benefit from social health insurance.
• Although the social health insurance system is mandatory, around 12% of the population remained uninsured in 2020, especially in rural areas.
• The unmet needs reported in Romania are more than twice the EU average, according to the annual EU-SILC survey in 2022, with direct payments above the EU average.
• Almost two-thirds of direct expenditure in 2021 was spent on the purchase of medicines. Although many medicines are fully covered by the social health insurance system according to a positive list of medicines included in the package, the rest are only partially covered. For these, patients make co-payments representing 10% of the cost price for generic medicines, 50% for expensive generic medicines and branded medicines, and 80% for medicines with a low medical technology score. In 2023, the government increased the income threshold at which pensioners make lower co-payments for medicines, meaning that pensioners pay only 10% of the cost price of expensive generic and branded medicines, while the state budget, through the Ministry of Health, covers another 40%.
• Direct spending in Romania is predominantly related to medicines.
• This highlighted vulnerabilities and challenges in countries’ emergency preparedness strategies and their capacity to provide healthcare services to their populations. In response to the severe effects of the pandemic – as well as other recent crises, such as cost-of-living pressures and the impact of conflicts such as the war in Ukraine – countries are implementing policies to mitigate the ongoing impact on service delivery, invest in health system recovery and resilience, improve critical areas of the health sector, and increase their preparedness for future shocks.
• The recovery and resilience plan prioritizes investment in hospital health services.
• Limited intensive care unit capacity and health workforce shortages have been bottlenecks in service delivery during the pandemic.
• Per capita health expenditure in Romania was the lowest in the EU in 2021. The social health insurance system that finances healthcare offers a comprehensive package of benefits. Compared to other EU countries, coverage is less generous for outpatient medicines and dental services. Although coverage is mandatory, around 12% of the population is uninsured.
• Romania is using a large part of the funds made available through the National Recovery and Resilience Plan, as well as EU cohesion policy, to modernise its hospital infrastructure. The aim is to ensure patient safety and reduce healthcare-associated infections, with further investments planned for the digitalisation of healthcare services and for improving the accessibility, effectiveness and resilience of the healthcare system.

DISCUSSION TOPICS:

PANEL 1 – How is Romania preparing to face a new health crisis?

• The financial situation of the Romanian health system, 17 months after the end of the COVID 19 pandemic as a public health emergency (WHO – May 5, 2023). On March 11, 2020, the WHO declared COVID 19 a global pandemic.

PANEL 2 – PANEL II: Investments in health. Research and innovation. Status of projects in the PNRR