What Health Care Reforms Are Bolojan and Rogobete Proposing?

Prime Minister Ilie Bolojan and Health Minister Alexandru Rogobete announced today, during a press conference (full statements available here), the main directions of a broad reform of Romania’s healthcare system. The statements addressed both structural issues affecting healthcare spending efficiency and concrete measures regarding salaries, public-private partnerships, and hospital management responsibility.

Bolojan: „We spend more, but patients see no improvement”

Prime Minister Ilie Bolojan warned that the CNAS budget has grown rapidly in recent years, reaching 16% of state revenues – a level comparable only to the pandemic period – yet this increase is not reflected in service quality or patient satisfaction.

„We have hospitals where salaries account for over 80% of the budget. The system seems to work more for employees than for patients. We must rethink incentives and performance criteria,” said Bolojan.

The Prime Minister announced that a performance-based salary model is being developed, along with a legal framework to allow swift intervention in cases of managerial inefficiency. Currently, hospital leadership receives funding without clear correlation to quality indicators.

Rogobete: „We’re not restructuring, but we demand accountability. If you can’t perform, step aside”

Minister Alexandru Rogobete stated that the reforms do not imply budget cuts or layoffs, but rather the proper redirection of funds and a deep rethinking of how the system operates.

„Being a hospital manager is not a privilege. It’s a responsibility. If you can’t deliver results, someone else should take your place.”

Rogobete announced a package of over 30 measures, including:

• introducing performance indicators for department heads,
• banning fictitious hospitalizations, with severe penalties for doctors,
• reforming specialty exams to align with European standards, not „held behind closed doors in the professor’s office.”

Patients between public and private: new rules for transfers and copayments

A major impact measure announced by the minister targets accountability for private hospitals. If a patient is discharged from a private hospital and ends up in the public system within 48 hours for the same condition, the costs will be covered by the private unit, not CNAS.

„There are patients who start treatment in the private sector but end up in the public system with worsened conditions. The state bears the full burden. We will shift cost responsibility to the unit that triggered the transfer.”

Additionally, the government plans to strengthen private insurance and eliminate copayments for patients treated in private facilities within a public-private partnership. The goal is for Romanians to access services in both systems without additional costs.

Hospitals reassessed, day hospitalization encouraged

Other announced measures include:

• Reevaluating and reclassifying hospitals based on competencies.
• Expanding day hospitalization for cases that do not require traditional inpatient care.
• Limiting CNAS’s monopoly by opening the market to private insurers.

Both officials emphasized that nothing can be fixed in healthcare without acknowledging the system’s harsh realities. The reform promises to be deep, and the message to patients is clear: they will not be affected by cuts or downsizing, but greater efficiency, transparency, and professionalism are required in managing resources.