Doctors in Bulgaria can earn more than their counterparts in Romania. The comparison comes as Romania's Sanitas union calls for an urgent meeting with the health ministry in Bucharest over cuts to staff spending.

The two health systems work in similar ways: everyone pays into one shared health fund, and hospitals are both state-run and private. The difference lies in how much people pay in. Romania's health insurance contribution is 10%, against 8% in Bulgaria. In Bulgaria, employees pay half of that themselves, while in Romania they pay the whole amount. Romania's health fund has about 15.5 billion euros to spend, three times what Bulgaria's fund has.

A specialist doctor in Romania takes home between 1,500 and 2,500 euros a month on average, and a head of department earns around 3,000 to 3,500 euros. That includes pay for night shifts, risky conditions and other extras on top of the base salary. Those are exactly the extras Romania's government wants to scrap.

In Bulgaria, pay can go even higher, especially at well-run state and private hospitals. That comes down to hospital managers and competition between hospitals. Where the rules on bonus pay are clear, Bulgarian salaries beat Romanian ones. Poor management, though, leaves state hospitals in debt, while private ones close or get sold. Trainee doctors also earn more in Bulgaria, and patients don't have to wait for a check-up.

In Romania, private hospitals charge patients extra, because the health fund only covers treatment up to a set amount. Some diagnoses are an exception, including cancer.

Doctors and orderlies at Romania's state hospitals held a national strike over a bill to cut pay in public healthcare. For three days, hospitals across Romania took in only emergency patients. After talks with the government, the protests were called off, but the union says it will restart them if there's no solution.

"We're not ending the strike — we're giving politicians a chance to rethink the situation," the federation said in a statement on Facebook, quoted by BTA.

The meeting was called over emergency order OUG No. 7/2026, which cuts spending on wages. The federation wants the same rules given to hospitals to apply to these workers too, and wants the government to move fast on the institutions affected.

Sanitas' list includes the public health directorates, the National Institute of Public Health, the National Blood Transfusion Institute and the blood transfusion centres, forensic medicine institutes and other state health bodies. The union says the whole public health system should be treated as one, since it's not just hospitals — the other units are just as essential a part of it.

Sanitas says the cuts have already lowered pay, left posts unfilled and made staff shortages worse, with extra work shifted onto the remaining staff. The pressure is falling on parts of the system that were already short-staffed. The federation wants the situation of the affected staff looked at urgently, and points out that people working in public health, disease prevention, blood transfusion and forensic medicine do work the system can't run without.

The second issue is the 2026 holiday vouchers. Sanitas wants clarity on exactly how they'll be handed out, and says people's entitlement to them should not be delayed — the government needs to give information and answers fast.

Federation chairman Julian Popa says the problems need solving no matter the political situation, and despite the health minister currently only holding the post in an acting capacity. The people the federation represents aren't to blame for the long political crisis, Popa said, and can't wait for the parties to form a legitimate government.

"Healthcare and social support can't be put on hold!" he said.

The federation also raised two new demands: a new pay law that is fairer, more consistent and equal for all, and talks with a body that actually has the legal power to act — either parliament or a properly appointed government.