Web-economic-crisis-health-systems-and-health-web

The Republic of Moldova
Valeriu Sava
Economic trends
• The Republic of Moldova's real per capita GDP growth quickly recovered
from a contraction in 2009 and in 2010 and 2011 was among the highest
in the European region. The budget deficit, while increasing in 2009, was
below the European mean in 2010 and 2011.
• Unemployment rates have consistently been below the European mean
from 2008 through 2011.
• Ten-year bond rates remain high relative to other European countries.
• While the size of government expenditure relative to GDP declined after
2009, the level of health spending remained stable, close to the European
region mean. This decline in the overall size of government expenditure
meant that public per capita health spending declined in 2010 by 4.3%;
however, OOP expenditure has continued to increase (Republic of
Moldova: Figs 1 and 2).
Policy responses
Changes to public funding for the health system
• Public spending on health fell in 2009 but remained stable in 2010 and 2011.
• The government health budget increased slightly from 2010 to 2012.
• The mandatory health insurance (SHI) budget grew in 2010 and 2011
and was expected to grow in 2012 but in July the Law on Mandatory
Health Insurance was revised to approve a deficit of around € 5.3 million,
which was financed using SHI reserves.
• Transfers from the state budget to SHI increased by 7% to compensate
for falling SHI revenues from payroll tax (2010); transfers from the state
budget to SHI on behalf of non-contributing people fell, as a share of SHI
revenues, from 56.3% in 2010 to 54.5% in 2011 and 52.8% in 2012;
• The discount for people self-purchasing SHI cover was increased from
50% to 75% of the flat-rate contribution for poorer people and for
socially disadvantaged self-employed people, mostly from the agricultural
sector (since 2010); the deadline for yearly contribution payment was
postponed from 31 March to 31 October (in 2011 and 2012).