The impact of implementation of medical insurance on health indicators of population in the Republic of Moldova

Abstract

Introduction. Medical insurance is a form of health care based on principles of solidarity, constituted by pre-established payments with the purpose of covering the treatment costs of insured events. By estimating the total risk of a group of people, an insurer can develop a stable funding structure, based on annual/ monthly contributions that will form a budget. It’s administered by an organization, such as a government agency, a private business, or a nonprofit organization. Health care has a major relationship with the economic activity of a state. It provides directly healthy workforce and social welfare, depending on the attention given to it. Following the evolution of the insurance system in a state, we can assume how the healthcare reforms will be developed in future. Medicine has a direct influence on the social and economic activity of the Republic of Moldova (RM), which requires a thorough analysis of the evolution of the health system in order to realize once again what stage we are and what should be done. Aim of the study. To determine the impact of implementation of medical insurance on health indicators of population in the Republic of Moldova. Materials and methods. We evaluated the evolution of health indicators in RM before and after implementation of medical insurance and reported them to other countries by making a comparative and descriptive analysis. Results. Before adopting the medical insurance, healthcare budget was totally dependent on the state budget. The last one was weakened because of the instability of economic relations with other states, the closure of factories, migration of population. Under these conditions, the budget allocated to health decreased between 1996-1999 by 31%, per capita being allocated below 10$. Healthcare expenditure of GDP experienced a surprising drop from 6,69$ in 1996 to 2,9% in 1999. Following the implementation of health insurance, the medical system raised. RM invested 10% of GDP for health in 2015, even over some European countries. The total health expenditures were 12.36 billion lei, and the total income in the insurance funds was 5.1 billion lei, compared to 361 million lei in 1999.<br /> However, the economic crisis caused the massive devaluation of the national currency in 2015 reduced total health spending in dollars by 17.67%. All this happened despite the fact that the budget in national currency has increased. Conclusions. The health system after the implementation of the medical insurance has made a significant progress but has always been negatively influenced by the low economic development of the country. What again emphasizes the interdependence between economic, social and medical factors.Positive evolution of health budget should always be reported to an international currency, in order to avoid mistakes of interpretation due to fluctuations of the local economy.