Government opens competition between public and private hospitals in Romania

Private hospitals in Romania will be paid by the state to provide emergency medical services and treat patients with chronic diseases, the Government decided in an emergency ordinance. This is one of the biggest changes in Romania's healthcare system in the last 30 years.

Romania’s Liberal Government led by prime minister Ludovic Orban adopted on Tuesday, February 4, an emergency ordinance that allows private hospitals to provide emergency medical services and be paid by the state. The same ordinance allows private hospitals to participate in the national programs for the treatment of chronic diseases, for which the costs are also covered by the state. Patients will not have to pay anything extra (co-payment) for either of these services, according to the bill.

So far, public hospitals were the only ones that could provide emergency services paid for by the state. Meanwhile, the treatment of patients with chronic conditions, for which the cost is covered by the state through national programs, was also reserved for public hospitals. Private hospitals could participate in such programs only if public hospitals lacked capacity.

The emergency ordinance adopted by the Orban cabinet on probably its last day in office thus opens the competition between public and private hospitals for public funds.

The ordinance provides that private hospitals will not be reimbursed higher sums that public hospitals for similar emergencies and that private hospitals can’t ask the patients to cover extra costs (the so-called co-payment). The list of private hospitals that will be allowed to provide emergency services will be approved by order of the health minister. Private hospitals will be required to meet certain standards to get authorization.

The second change brought by the emergency ordinance is allowing private hospitals full access to the national programs for treating patients with chronic diseases such as cancer, HIV/AIDS, tuberculosis and cardiovascular diseases. The treatment for these conditions is covered by the state. Private hospitals were only allowed to participate in these programs when the capacity of public hospitals was exceeded. This restriction will not exist anymore and patients will be able to choose to get treated in private hospitals. Moreover, the private hospitals will not be allowed to charge extra for the services provided under these national programs.

Opposition politicians criticized the ordinance claiming that it represented the “privatization” of the public healthcare system.

The emergency ordinance was drafted by the new health minister Victor Costache, a cardiovascular surgeon schooled in France who works for the biggest private medical services provider in Romania, MedLife. In fact, local newspaper