The Bulgarian Medical Association has called for an urgent overhaul of healthcare funding, insisting on a 25 percent increase in the prices of clinical pathways and all medical services, alongside a revision of the user fee for hospital stays. Speaking to journalists, BMA Chairman Dr. Nikolay Brunzalov said the organization is seeking immediate negotiations and the signing of an annex to the National Framework Agreement with the National Health Insurance Fund, which would allow for a rapid update of pricing across the system.

“Our request is for immediate talks… to ensure an urgent update of all medical activities by at least 25%,” Brunzalov said, stressing that such a move requires not only time and dialogue but also political will. He argued that the caretaker government has a responsibility to guarantee stability and fairness in the healthcare system at a moment of growing strain.

According to the BMA, the sector is facing serious financial pressure, with overall costs rising sharply in recent years. Brunzalov pointed out that expenses have increased by around 75 percent, while wages in the sector continue to grow and the prices of medical services remain frozen at levels from April 2024. This imbalance, he warned, is leading to accumulating deficits and rising tension within the system, adding that “the health system is on the brink.”

The association says it has received numerous warnings from hospitals across the country, including university, municipal and private facilities, all reporting worsening financial conditions and difficulties maintaining daily operations. These signals, Brunzalov noted, reflect a systemic problem that requires “an immediate and extraordinary solution,” including the allocation of additional funding similar to that provided to other sectors.

Deputy Chairman Dr. Ivan Madzharov also challenged claims that no action can be taken by the caretaker authorities. He argued that steps are still possible, including proposing a return to the previous level of the hospital user fee, which had been reduced from 5.60 leva to 1 lev. He added that by the time a new budget is adopted, updated pricing should already be agreed. “It is not true that the acting minister cannot take action,” he said.

The Health Ministry, however, has pushed back on some of the demands. Acting Health Minister Assoc. Prof. Mihail Okoliyski stated that adjusting the prices of clinical pathways is not feasible without an approved budget. At the same time, the BMA has criticized recent regulatory moves, arguing that changes ordered by the ministry could impact the NHIF budget without proper financial backing.

The call for reform has been supported by several healthcare organizations, including representatives of private hospitals, the Bulgarian Hospital Association and general practitioners, who joined the discussion and echoed concerns about the system’s long-term sustainability.