The Romanian Healthcare System: where challenges provide opportunities

Romania is located in Southeastern Europe, houses a population of 19.8m, and has a nominal GDP of €154 bn, at a 3% growth rate. In this article we will highlight some of the biggest challenges to the well-being of the Romanian healthcare system. Where there are many challenges and weaknesses, one can assume that there is a great opportunity for improvement, innovation and growth, if the right tools for growth are applied.

Romania presents an interesting market, as it is the 12th largest country in the EU. In terms of land mass it is comparable in size to the United Kingdom, and just over a third the size of Germany. It joined the EU in 2007, and is geared to improving its healthcare system, which unfortunately suffers several deficiencies at the moment, resulting in overall poor health outcomes.

Healthcare expenditure is amongst the lowest in Europe

Romanian healthcare expenditure in 2015 as a percentage of GDP is 5.6%. In comparison its neighbor Ukraine spends 7.7%, Hungary spends 8.2%, and Germany spends 11.8% of its GDP on healthcare. European nations, including the Central Eastern nations and Central Europe, on average spend close to 10% of GDP on healthcare, accordingly Romania is far below this average.

Why is Romania’s healthcare struggling?

Romanian healthcare suffers from several structural and financial weaknesses, that have led to an underperformance and under-spending on healthcare, which is vastly reflected through many negative and low health status indicators and treatment outcomes.

The rural areas particularly, demographically housing the most vulnerable of the Romanian society, suffer from a lack of access and availability of healthcare facilities.

Corruption, tax evasion and defaulting on social contributions, are unfortunately not uncommon, and heavily tax the financial viability of the national insurance fund, which is dependent upon these funding sources.

An underdevelopment of the primary care sector, along with a disproportionate spending on inpatient care, further burden the organizational structure of the healthcare.

Medical professionals are seeking job opportunities elsewhere

Despite medical staff being well-trained and healthcare being universal by design, the citizens experience an inaccessibility and insufficiency of healthcare services. Understaffed facilities are common due to a vast emigration of medical staff.

GPs and specialists in Romania are amongst the worst paid on a European scale. With a minimal monthly wage of around 370 Euros, they earn 2.1 times less than in Poland for the same position, 5.9 times less than in Sweden, and 10.4 times less than in Germany.

Shortages of near-by healthcare units (including pharmacies), lacking supplies in existing facilities, insufficient infrastructure, and low healthcare spending per capita are some of the most prominent issues troubling this healthcare system.

Bountiful demand is waiting to be supplied

What we see is a lot of room for improvement, and a great need for medical supplies and business opportunities.

State plans for the next 5 years list a variety of medtech needs and emphasize the intention of enhancing county hospitals and various specialty fields by increasing capacity and quality, through technology and medical equipment supplies.

Public-Private-Partnerships and investments into infrastructure are expected to attract business and facilitate growth.

In comparison to the public sector in the last 10 years, the private sector in Romania has been bustling and growing. In situations where it is logical and cost-effective, the private sector is contracted by the national/district insurance funds, and reimbursed by the public sector for its services.

There are opportunity: the Romanian healthcare market is and will continue to grow

Despite the overall impression that the Romanian healthcare system is amongst the least strong in Europe, the Romanian government has been concentrating with greater commitment in recent years on ameliorating the present healthcare weaknesses and funding issues. The World Bank and the EU Council are also actively involved with restructuring and boosting healthcare in Romania, both financially and in terms of regulation.

Accordingly, TforG expects a greater state budget –and spending accordingly- on the healthcare sector in the coming years, greater market efficiency, transparency and regulation, and increased and favorable business opportunities to push local and foreign investment, and healthcare-related activities.

For further quantitative and qualitative information on the Romania healthcare system and the macroeconomic climate, please look into our Business intelligence platform or order the TforG Deep Dive report for Romania containing volumes of 984 unique surgical procedures in 13 specialisms.