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care system and we are way away from this number. There are some solutions, in my opinion. We now only speak of an adequate financing, of the tendency to reach at least the 6 % of GDP which I was talking about. I will refer later on to the management of this amount of money. This money must be very well managed and that, independent of the quantity; avoiding leaking, fraud and so on. But this is the other side of the issue. We now only speak of augmenting the financing. All control mechanisms of such funding are already in function. What could we then use as additional money sources for the health budget? Firstly, it is about the health tickets. Health tickets are estimated to provide an additional 1–1.2 billion LEI. The 2.7% of GDP means an approximate 15 billion LEI. Anyway, 6 % of a GDP of around 530 billion is approximately 32 billion LEI which is the double of what the health system has. The health tickets are estimated to provide us with approximately an extra billion which is quite little. The ticket role is, however, very important and that, from two points of view. Firstly, it is the citizen’s empowerment. There currently exists a tendency among people to believe, such as in communist times, that health care is for free and that it should be offered to people for free by the government. Health care is not for free; this fact is obvious in the contemporary world. The more sophisticated and the more high quality health care are, the more expensive it will be. Paying for medical care, even though a small amount, increases thus people’s awareness, showing that medical care is not for free and that the insured must also add a financial contribution to the act. The second consequence is in terms of discipline and we were able to sort that out in countries where this system of double paying was put in place. The system also brings about a certain discipline on behalf of the personnel leading to the erasing of illegal practices such as non real hospitalizations or health care abuse on behalf of the patient. This system should lead to the apparition of a more health aware citizen who knows that health care is both needed and expensive; it therefore costs. Another mechanism of augmenting the health care financing is the enlargement of the paying basis. Now, about 5 mil. citizens ensure the health cost of 20 mil. of inhabitans. COSTS AND QUALITY OF HEALTHCARE PROVISION IN THE ROMANIAN HEALTH INSURANCE SYSTEM

Costs and quality oh healthcare provision in the Romanian Health Insurance System