THE BASIC MEDICAL SERVICE PACK – PROBLEM ANALYSIS AND POLICY RECOMMENDATIONS

The problem of defining the Basic Medical Service Pack (BMSP) has been on the public agenda since the introduction of the compulsory health insurances as a tertiary source of payment for illness care. The cost is determined by its contents and especially by its degree of usage which, in its turn, is influenced by the payment mechanisms and by possibilities of payment. No balance has been achieved yet. The payment capacity (incomes) has always been lower than the expenses generated by the medical services. Health revenues have two main sources: the unique national fund of health insurances (UNFHI) and the state budget. The UNFHI contribution should cover the expenses for services provided to diagnose and treat the insured patients who pay, while the state budget incomes should be granted to those patients that are exempted from paying insurances, should ensure financial support for personal contributions that the insured have to pay for some medicine, medical devices or other services provisioned by the framework contract on whose basis the contractual relationships within the system are carried out. The analysis of BMSP should take into account the elements that define the BMSP: the list of discounted services; the way services are accessed by the insured; the means of contracting; means of payment. In the Romanian context, the basic medical service pack has to be reconfigured in order to develop the payment and control mechanisms that allow for improvement in health indices, for higher expense effectiveness, that are easily controlled, that do not trigger inflation of services and stimulate the healthcare professionals to achieve the best results. Keywords: basic medical service pack, health policies, Romania.