Dimitar Ganev, Trend: Bulgarians want more funding for health, but 58% do not accept an increase in health insurance contributions

Only 30% of doctors in Bulgaria support the idea of patients verifying the medical activities performed on them, while 56% are opposed. This is according to a sociological survey by “Trend” among 800 practicing physicians, conducted between June 24 and July 13, 2025, commissioned by the Bulgarian Medical Association (BMA) and presented at the 7th National Congress on Healthcare Policies.

Regarding sector regulation, opinions are divided: 35% want more regulation, 36% prefer the current level, and 10% believe that control should be reduced. Although 91% rate collegiality among medics as very good or good, two-thirds believe that more active promotion of ethical standards is necessary.

Regarding remuneration, 72% of doctors believe that the fairest model is compensation based on activity and qualification. Doctors expect the Bulgarian Medical Association to work most actively for transparency in the distribution of funds (69%), protection of rights and working conditions (67%), and protection from administrative pressure (56%).

The second part of the study covers 1,002 adult citizens and analyzes public attitudes toward healthcare financing. 46% of Bulgarians believe that public funds for health should be increased, and 49% rank healthcare as the highest priority for the state budget in the coming years. The strongest support for higher funding comes from people over 60, university graduates, and residents of the capital.

Nevertheless, 58% of respondents oppose an increase in health insurance contributions, with only 27% supporting it. Support is higher among the elderly and residents of Sofia—groups that likely rely more on the health system or would not be directly affected.

Distrust in the management of funds remains strong: 84% of Bulgarians believe that control over expenditures in the system is insufficient. Only 3% believe that control is adequate.

Regarding willingness to make additional payments:

• 36% would pay out of pocket for faster access to a specialist

• 30% – for innovative therapies

• 26% – for modern medicines not covered by the National Health Insurance Fund (NHIF)

• 26% would not pay anything extra

The results show a strong desire for better financing and control in healthcare, but also a clear public reluctance to increase personal financial commitment through higher health insurance premiums.