The current patient fee for a medical consultation has lost its purpose and no longer serves its intended functions, according to Bulgarian Medical Association (BMA) chairman Dr. Nikolay Brunzalov. Speaking on bTV, he noted that the charge has remained frozen at BGN 2.90 for years, while pensioners pay just BGN 1.

Earlier this week Brunzalov suggested that the fee should either be scrapped or increased. Today, appearing on Nova TV, he clarified that he had been misunderstood: “I never called for its abolition. What I said is that it has been so devalued over the past 15 years that it no longer makes sense,” he explained.

According to him, the fee should serve two purposes – to provide additional funding for healthcare facilities and to discourage overuse of medical services. “In its current form, it does neither. Imagine a doctor who examines a patient, prescribes medication, and in return receives just one lev – it’s like a street musician playing for coins,” Brunzalov said.

He also warned about practical problems once the fee is officially converted into euros. “The fee will be 51 eurocents. A patient pays 20 leva, and the doctor must return change in euros and cents. Is this what medical practice has come to – petty cashier’s work?”

The BMA proposes linking the fee to the minimum wage, setting it at 1% – currently BGN 10.77. “This way, it will update automatically and won’t demean doctors’ work. We’re ready to negotiate so past mistakes, when it was fixed in levs, aren’t repeated,” Brunzalov added.

He also reminded that large groups are exempt – children, people with chronic illnesses, and those meeting disability or social criteria. “This is social policy, but it comes at the expense of doctors’ labor. In the digital age, hanging exemption lists on clinic doors is absurd,” he said.

The issue comes as Bulgarians continue to top the EU ranking for out-of-pocket healthcare costs. Meanwhile, the NHIF is running an unprecedented deficit, already exceeding BGN 400 million this month following the removal of spending caps.