Healthcare in Romania

Romania benefits of an universal healthcare system. The access to healthcare is guaranteed by Article 34 in the Constitution of Romania, which states that the state is obliged "to guarantee the sheltering of healthcare" . Romania has a fully universal health care system, which covers up medical check-ups, any surgical interventions, and any post-operator medical care, as well as free or subsidized medicine for a range of diseases. The state is also obliged to fund public hospitals and clinics.

The Romanian Ministry of Health is in charge of administrating and funding the system. For 2012, the allocated budged for the healthcare sector is 12 billion euros, or roughly 5% of the GDP.

Every citizen of the European Union is entitled to free emergency medical assistance/procedures.

2011 proposal of privatization

In November 2011, the Government has announced and proposed a completely new healthcare system. The main changes are: the privatization of all hospitals and public clinics, the replacement of the public NHCIS with private insurers and the mandatory contribution to a private healthcare contractor. As president Băsescu declared, "Hospitals must become Plcs or charity institutions, the management must be privatized " Furthermore, the changes also mention the fact that diseases should be treated with local, generic medicine rather than expensive treatments and that doctors will be able to negotiate their salary. The people who are not required to co-pay are teens under the age of 18, people with a monthly income of less than 150€ or people without an income at all.

The project has been withdrawn in January 2012. It has caused a great controversy and received extensive media coverage. As a result of the proposal, Raed Arafat has quit his job as a state secretary. This caused protests in Bucharest and other major cities in Romania. The protests ceased on the 6th of February.

See 2012 Romania protests.

Facilities and equipment

Currently, there are 425 hospitals in Romania . Theoretically, each of the 425 hospital should be equipped with a basic trauma room and an operating theater. For each 1000 people, there are 6.2 hospital beds available.

Romania makes use of ~2,600 ambulances, and by 2015, the government is planning on purchasing an additional 1,250 ambulances.

Romania also has a professional emergency response unit, SMURD which operates at major emergencies. SMURD operates independently from the regular emergency response services, but it can be dialed ad asked for by calling 112.

Altogether (including air crafts/choppers from the military hospitals, SMURD and Internal Affairs], Romania has a fleet of 30 air crafts equipped for medical emergencies. .

Issues and challenges

Per capita, Romania has the lowest medical expenses inside the Union.

The medical system has been affected by a lack of medical staff. This is due to the low wages and the attractive working conditions in Southern Europe. Many medics and nurses have decided to go and work in the medical system in Italy, Spain and France.

Another issue is the high level of out-of-pocket spending. Due to the bribing that is "traditionally" practiced ever since the communist era, a sizable amount of patients have reported that they had to bribe the doctors and nurses in order to receive good treatment. Furthermore, another issue is that, in some cases, the hospitals lacked basic supplies, such as tampons and therefore, although the equipment and medicine is there, certain procedures cannot be done until the patient provides the supplies by themselves.

Most common causes of death

The most common causes of death are cardiovascular disease and cancer. Communicable diseases such as tuberculosis, syphilis, and viral hepatitis are more common than in Western Europe. The incidence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is less than 0.1 percent. However, high rates of venereal disease, lack of education about HIV prevention, and increasing intravenous drug use are factors that could increase the rate substantially in the future^{[citation needed]}. The number of pediatric AIDS cases is one of the highest in Europe because of unsafe blood transfusion and inoculation procedures for young children in hospitals and clinics in the last years of the communist era. In 2006 an estimated 7,200 Romanians below age 20 had been infected in this way.

History of the Romanian health system

The first concept of public healthcare appeared in 1700. (in the areas of the Contemporary Romania) This was around the time when foreign doctors were brought in to cure people.

The system has developed and by the mid 18th century, the aristocrats would send their children in Vienna to study medicine and return home with knowledge. In 1859, the University of Iași opened the first medicine department in Romania (known as the Principates at that time).

Hospitals in Romania

This is a list of the most historically relevant hospitals in Romania.

Colţea Hospital, in Bucharest, was built by Mihai Cantacuzino between 1701 and 1703, composed of many buildings, each with 12 to 30 beds, a church, three chapels, a school, and doctors' and teachers' houses. In 2011, the hospital has been fully re-equipped and is now one of the most modern hospitals in Bucharest.

Pantelimon Hospital was raised in 1733 by Grigore II Ghica. The surface area of the Pantelimon Hospital land property was 400,000 m². The hospital had in its inventory a house for infectious diseases and a house for persons with disabilities. The hospital is still operational today.

St. Spiridon Hospital, in Iaşi, opened in 1755, described in a document from 1757 as the largest in Moldavia and Wallachia, is nowadays the second largest in Romania.

Filantropia Hospital had a capacity of 70 beds and was built in 1806-1812, during the Russian occupation. The hospital is still operational today, but its medical facilities aren't as modern as other hospitals.

In 1830 the Brâncoveanu Hospital was inaugurated. The hospital worked on the same principle as a free clinic, offering various vaccines/medical tests free of charge. However, the urban development led to the hospital building being demolished (and therefore its activity ceased) in the mid 20th Century.

Romanian doctors

The Romanian healthcare system has been in existence since 1700. At that time, the doctors were primarily from France, Italy or Austria (in Transylvania). The first Romanian doctors graduated with degrees in medicine from universities in Vienna and Paris at the beginning of the 19th century (such as Ştefan Manega or Ioan Serafim).

The Romanian healthcare system has many unsung heroes. During the 1828 plague in Bucharest, 21 out of 26 doctors died of plague whilst administering treatment for the disease.

In the 20th century, the Communist regime encouraged students to join the medicine university. Doctors were usually given priority housing and had easier access to premium (roasted coffee beans, bananas etc) goods.

Since the fall of the communist regime, the amount of students interested into completing the medicine school has decreased.

Vaccination

Vaccination has been done in Romania ever since the 17th century, when people used rudimentary methods of vaccination, such as dipping newborns into cow milk coming from cows with smallpox.However, due to the increasing number of doctors, more modern methods of vaccination have been introduced. As of 1800, the children were being administered a regular smallpox shot.

From the 19th century up until today, it has became compulsory that all children get vaccinated against Hepatitis B, Tuberculosis, Tetanus, Polio, Rubella and Diphtheria. The vaccines are free of charge and can be done at any authorized pediatrics medic. Additional optional vaccines such as the one against the Flu are also provided free of charge on a bi-yearly basis.

Late 2000s private hospitals boom

Ever since 2007, when Romania joined the EU, the amount of private hospitals has raised. At the moment, there are 130 private hospitals/clinics in Romania.

The private hospitals have increased in popularity, especially since the 2011 proposal of privatization (see above) has came into discussion. More and more Romanians are choosing to opt for a private insurance plan, which includes access to a private hospital.

A few reasons for this sudden shift is the fact that private hospitals offer premium services. They tend to be more patient-friendly than the public hospitals, and they also have modern equipment. Another notable aspect is the fact that the staff is usually banned from receiving any sort of bribe, which makes many Romanians (particularly from the <50 generation) keen to join a private clinics network.

However, criticism has been brought to the private hospitals, because although most of them are equipped with state-of-art medical machines, if any serious medical emergency occurs (e.g. massive internal bleeding) o, the patient is being transferred to a public hospital. This is usually done because public hospitals have more specialists who might be more competent than the ones in the private hospitals.

Medical universities and faculties

• Victor Babeş University of Medicine and Pharmacy of Timişoara
• Carol Davila University of Medicine and Pharmacy of Bucharest
• Grigore T. Popa University of Medicine and Pharmacy of Iaşi
• Iuliu Haţieganu University of Medicine and Pharmacy of Cluj-Napoca
• University of Medicine and Pharmacy of Craiova
• University of Medicine and Pharmacy of Târgu Mureş
• Faculty of Medicine and Pharmacy of the Ovidius University of Constanţa
• Victor Papilian Faculty of Medicine of the Lucian Blaga University of Sibiu
• Faculty of Medicine and Pharmacy of University of Oradea
• Faculty of Medicine of Transilvania University of Braşov
• Faculty of Medicine and Pharmacy of the Lower Danube University of Galaţi
• Faculty of Medicine of the Vasile Goldiş Western University of Arad (a private university)

Telemedicine

Romanian National Partnership in Telemedicine

Romanian Partners for the Pilot are:

• "Sfântul Ioan" Hospital, Bucharest;
• University Hospital, Bucharest;
• Military Hospital, Bucharest;
• Floreasca Emergency Hospital;
• "Victor Babeş" Hospital, Bucharest;
• "Sfânta Maria" Hospital, Bucharest.
• "Sfântul Spiridon" Hospital, Iaşi;
• Craiova County Hospital;
• Timişoara County Hospital;
• Târgu Mureş County Hospital;

See also

• SMURD

External links

• Romania: health profile from the DFID Health Resource Centre.
• Healthcare Systems in Transition: A Profile on Romania from the World Health Organization
• Bribes for basic care in Romania from The Guardian Weekly