The Bulgarian Medical Union (BLS) has issued a warning that the country’s healthcare system is approaching a critical point, calling for urgent state intervention to prevent further deterioration. In a statement by its National Council, the organization says the situation requires immediate measures and insists that the Minister of Health take action as a mediator between the union and the National Health Insurance Fund (NHIF).

A key demand is the urgent signing of an annex to the National Framework Contract, aimed at updating the prices of all medical activities. According to the BLS, current financing levels no longer reflect the real costs faced by healthcare institutions, creating a widening structural gap in the system.

The union warns that hospitals and medical facilities are operating under a growing financial strain, driven by sharply increasing expenses for energy, medical supplies, maintenance, and staff remuneration. It describes the system as being under a severe and deepening deficit pressure.

Data cited by the BLS shows that between 2021 and 2025, average costs in the sector rose by 85%, with nearly 18% growth recorded in 2025 alone. Personnel expenses increased by 74%, influenced by higher minimum wages, adjustments in social security thresholds, and the need to retain qualified staff.

Despite this rise in costs, the prices paid for medical services remain unchanged at 2024 levels, with no updates introduced in 2025 or 2026. The union argues that this mismatch between rising expenses and stagnant reimbursement rates is creating serious financial imbalance, leading to accumulating deficits and increased risk of shifting costs onto patients.

The BLS also notes that while public revenues have increased, including through higher wages and social contributions, the additional funds are not being directed toward stabilizing the healthcare system. It contrasts this with other sectors where the state has introduced extraordinary financial support measures through government decisions.

The statement further stresses that broader economic uncertainty and ongoing geopolitical tensions are adding pressure on healthcare costs and system stability. The union warns that continued inaction could intensify financial strain and ultimately increase out-of-pocket payments for patients.

The organization rejects claims that the healthcare system has sufficient or even surplus funding, arguing that such assessments ignore the fact that medical staff are effectively compensating for shortages through increased workload and personal strain.

The BLS National Council concludes by demanding immediate agreement on updated pricing under the National Health Insurance Fund framework, stating that this is essential to ensure system sustainability, maintain access to medical services, and provide stability for healthcare professionals. It emphasizes that healthcare cannot function with outdated pricing in the context of rising costs and that timely political decisions are urgently needed.