Bulgarian general practitioner (GP) doctors protested against the Government's proposal to waive the 2.20 leva visitation fee starting from January 1 2009, Dnevnik daily reported on March 11. Antonia Parvanova, member of Parliament (MP) from the National Movement for Stability and Progress (NMSP) and a member of the health care reform working group, broke the news a day earlier.

According to the doctors, the free visits will cause long queues outside their offices and will make access of patients to treatment more difficult.

One doctor collects 1000 leva a month from visitation fees and the entire GP community generated 30 million leva a month. The money is used to pay salaries to nurses and rents, the National Union of General Practitioners (NUGP) said. According to the head of the union, doctor Lyubomir Kirov, rash reforms might create grounds for corruption and that is to surely worsen relations between specialists and patients.

The doctors offered to include the visitation fee into the consultation fee or to ask a fee from the patient, who was to later get reimbursements from the health funds. The other union idea is home consultations to cost 22 leva, a fee to be paid and later again reimbursed by the health insurance funds.

Kirov argued that plans to strip the National Health Insurance Fund (NHIF) off its monopoly were good, provided that they created real competition. But the general feeling among GPs was that political parties used the NHIF issue to kick off the parliamentary campaign early, he added.

But even that took a back seat to the main goal, which NGUP believes to be the “absorption” of one billion leva that will flow into the budget on the back of the increase of health insurance contributions. Private health insurance funds would surely be profit-driven and health insurance proceeds they attracted would hardly be used for health care or doctors' salaries.

The union forecast that the health insurance contribution will undergo phased-out hikes to 12 percentage points, as is the case in most European states. It is necessary to prepare forthcoming reforms in the atmosphere of full transparency to discard lobbyism doubts, Kirov said.