In the absence of an adopted state budget, the new National Framework Agreement for medical activities cannot be signed and the current agreement will remain in force, said to journalists the chairman of the Management Board of the Bulgarian Medical Association (BMA), Dr. Nikolay Branzalov, before the start of the 79th extraordinary meeting of the union.
The delegates of the forum must vote on the parameters under which the National Framework Agreement for the period 2026–2028 will be signed. The document defines the conditions, medical activities and rules by which doctors work in outpatient and inpatient care, as well as the volumes, activities and their prices for clinical pathways. The current National Framework Agreement for medical activities for 2023–2025 was signed between the Bulgarian Medical Association and the National Health Insurance Fund (NHIF) on September 1, 2023.
"Today we will introduce our colleagues to what we have achieved in the negotiation process. We will indicate the prices of medical services as they were laid down in the last draft budget, which was withdrawn anyway. We will leave it to the colleagues from the Assembly to decide what course of action we will follow from now on," explained Dr. Branzalov.
According to him, the political confrontation, the resignation of the government and the resulting lack of a budget will affect every citizen of Bulgaria. "Therefore, I urge politicians to show wisdom and do it where they can help Bulgarian society. Because this is their job - they are members of parliament," he commented.
According to Dr. Branzalov, the health system in Bulgaria is seriously underfunded. A heavy political decision is needed to increase health insurance contributions. If this does not happen, by 2040 the country will suffer very large losses - not only because of the people who work in healthcare, but also for the whole society, warned the chairman of the BMA.
The new framework agreement, according to him, contains many positive agreements for both patients and doctors, but in the current political and budgetary situation these changes will not be able to come into force. In the absence of an adopted budget, the signing of the National Framework Agreement is impossible, Dr. Branzalov emphasized.
In response to a question about what is happening with young doctors and the planned increase in their salaries, he stated that the BMA categorically supports the increase of salaries of all medical specialists – both young and the rest of their colleagues in the system. "Our opinion has not changed – we are against the financing of structures. We are for financing activity, as is the current model," he added.
Dr. Branzalov expressed hope that a clear policy will be developed in which the Ministry of Health will also actively participate, so that all these colleagues will be additionally financially supported until the moment of acquiring a specialty. According to him, the same approach should also apply to other health care specialists – during the first five years after graduation, they should receive targeted financial support, and then go out on the free labor market, "like everyone else".
Against the backdrop of the debate in the sector, the political crisis in the country has deepened. After another round of mass protests, Prime Minister Rosen Zhelyazkov announced on Thursday that the government was resigning. If the parliament does not adopt the State Budget Act by the end of the month, the cabinet will submit an expanded budget to fulfill this obligation, Zhelyazkov also pointed out.
Later the same day, GERB leader Boyko Borisov stated that the parliament would not consider any budget. He added that his party would try to help limit the rise in prices, but stressed that "the caretaker government is no longer working" and citizens should be aware of this.