BMA: The Healthcare System Is on the Brink; Urgent Measures and Price Updates Are Required

The National Council of the Bulgarian Medical Association warned that the healthcare system faces a serious risk of collapse and demanded immediate action from the state. The professional organization calls on the Minister of Health to take steps for the urgent signing of an annex to the National Framework Agreement with the NHIF, which would ensure an update of the prices for all medical activities.

The BMA emphasizes that the system is under intense financial pressure due to the sharp increase in costs in recent years. Data shows that in the period 2021–2025, the average costs of healthcare facilities increased by 85%, with growth reaching nearly 18% in 2025 alone. There is also a significant increase in personnel costs—by 74%—which is explained by the rise in the minimum wage, social security thresholds, and the need to retain medical staff.

At the same time, the prices of medical activities remain unchanged at 2024 levels, with no updates scheduled for 2025 and 2026. According to the Medical Association, this creates a serious imbalance—costs are rising while funding lags behind, leading to the accumulation of deficits and tension within the system.

The organization warns that in the absence of a response, the risk is that the burden will be shifted onto patients through increased out-of-pocket payments. “Healthcare cannot function at prices from the past with costs from the present,” the BMA stated.

According to the professional organization, a paradox exists—despite increased collection of public revenues, including health insurance contributions, these funds are not being used effectively to stabilize the system. Meanwhile, the state is taking extraordinary financial measures in other sectors, but healthcare remains excluded from this process.

“The system relies on the efforts of those working within it, who daily compensate for deficits with their labor and health,” the BMA stated, warning that such a practice is unsustainable.

The National Council demands an urgent increase in the prices of medical activities across all sectors, which they believe is key to guaranteeing the sustainability of the system, maintaining access to quality medical care, and ensuring stability for medical professionals.

The BMA emphasizes that the necessary decisions cannot be postponed, as continued inaction amidst economic and geopolitical crises poses serious risks to the functioning of the healthcare system.