Здравната система в България и влиянието на...
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BYPrACKH CBOEOflEH YHHBEPCHTET "IIPEAH3BHKATEJICTBA HPEfl BHCUIETO OBPA3OBAHHE H HAY^HHTE H3CJIEflBAHHH B YCJlOBimTA HA KPH3A" TOM BTOPH BYPFAC - 2010
Transcript of Здравната система в България и влиянието на...
BYPrACKH CBOEOflEH YHHBEPCHTET
"IIPEAH3BHKATEJICTBA HPEflBHCUIETO OBPA3OBAHHE H HAY^HHTE
H3CJIEflBAHHH B YCJlOBimTA HA KPH3A"
TOM BTOPH
BYPFAC - 2010
PEJAKUHOHHA KOJIEFlifl
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BCHMKH npasa caaanaaeHu!He ce paapeuiaBar Koniipane, BTianpoinBOKflaHe n pa3npocTpaHennejjoKJiafliiTe HJIH nacTH OT rax 6e-j nncMenoro paapemeHHe na aBropiiTeABTOpHTC HOCHT RtJIFia OTFOBOpHOCT 33 aBTOpCTBOTO CM, K3KTO II
rpciiiKH, aonycHaTii no Taxwa Buna.
ISBN 978-954-9370-71-3
ECY Me/Kay n upojiiia KOH^eeHUHfl - 2010
HJIEHAPEH AOKJIA/l
Opotf). ATII XPHCTO XPHCTOB, VHHBEPCHTETCKOTO OKPA3OBAHHE -KAMECTBO, TEHflEHUHH H HOPMATHBHA OCHOBA ............................................... 8
HKOHOMHKA, OHHAHCH H HHBECTHIJHH
Ninko Kostovski, Milen Baltov, PROSPECTS ON THE ACADEMICENTREPRENEURSHIP IN BULGARIA AND MACEDONIA .......................................... 16
Hoaap Xaaypii, OCHOBHblE HAnPABJlEHH.il PEOOPMbl BblCUJEro3KOHOMH4ECKOrOOEPA30BAHHJl B HPOIJECCEnOCTKOMMyHHCTH4ECKOHTPAHC0OPMAUHH ......... . ........................................ 21
Flpcxf). JIorBiiHOB C.A, OPOEJIEMbl COUHAJlbHO-3KOHOMHlIECKOroPA3BMTHH POCCHH B nOCTKPH3HCHbIH tlEPHQR. ................................................ 29
Pajncjiae UOHICB, KpaciiMiip KncTenapOB, TIICTBAHE HA CAPM CH3HOJI3BAHETO liA PA3JIHHHH 3AMECTHTEJ1HHA FIA3APHHJI HOPTOEHJI HA bWlFAPCKHJI KAOHTAJ1OB RA3AP .................... 37
GraivioBa, A.ieKcaiuT.p CraMOB,MOflEJI 3A ^BH)KEHHE HA L|,EHHTE HA CTOKOBR5I HA3AP ................................. 45
AiiMirrpoBa, HHCTHTyUHOHAJlbHblE HPOBJIEMbl0OPMHPOBAHHJI ME^OBEHECKOrO KAFIHTAJIA ................................................... 51
BiioJiera Kacbpoaa, MO^EJIH 3A OHHAHCOBA ^HAfHOCTHKAB CTOHHOCTHO OPHEHTHPAHOTO yilPABJIEHHE ................................................. 55
Teopni MapiiHOB, TJIOBAJJUHJIT KJ1HMATMHEH HPOBJIEMH nOJIHTHKATA HA EBPOHEilCKM C^FO3 .............................................................. 62
MeneuieB, TyPMCTHHECKATA PEKJ1AMA -HA4HH HA ynOTPEBA ................................................................................................... 68
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MapKO JI.TuMHeB, EBPOREHCKHTE CTAHflAPTH B OBVHEHHETOHO ,,d*HHAHCOBO-CTOriAHCKH (EH3HEC) AHAJ1H3 ............................................... 81
BCV MemjiyHaponHa K n i u j i t p c i m n s i - 2010
MapKO Jl.THMieB, flHCTAHUHOHHATA <POPMA HA OEYHEHHE00 ,,*HHAHCOBO-CTOHAHCKH (EH3HEC) AHAJIH3 B ffVXAHA EOJIOHCKHJi HPOU.EC H JIMCAEOHCKATA CTPATErHJl .................................. 87
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Coim AOKOBS, nO^XOflH 3A OPOBE)KflAHETOHA KOHBEPfEHTHO PA3BHTnE HA HAUHOHA^HOTO HPOCTPAHCTBOH OOPMHPAHE HA PEFHOHAJIHUTE HA3APH ........................................................ 1 1 1
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BomnaKOB, nEPCHEKTHBH3A PEFHOHAJIHOTOPA3BHTHEB EC ............................................................................................................. 152
Pocima H. HeaHtma, VC"bB'bPIlIEHCTBAHE HAHAVHHO-HSCJIE/IOBATEJICKATA H nPEOOAABATEJICKA PAEOTAHO "OHHAHCOBO-CTOHAHCKH (BH3HEC) AHAJIH3"B HKOHOMHHECKHTE BHCI1IH YHEBHH 3ABE/JEHHMB YCJIOBH^ HA KPH3A ................................................................................................. 160
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Pajniiia AiiMiiTpoaa, KOPEKU.HH HPH H3HHCJIJIBAHE HA LJEHATAHA KAnHTAJlA B YCJ1OBHJITA HA 4>OPMHPALUCE HA3AP 179
Hue-mma HeTKosa JKcieoa-PafleBa, MEXAHH3MH 3A HO^OEP^IBAHE HAVCBOJ1EMOC1TA HA CPEflCTBATA HO OHEPATHBHHTE HPOFPAMH 187
ECY Me/Kjiynapoaim Kaii(])epeHiiim - 2010
MapcejieH MerSe Hoeoraii, OHHAHCOBHJ1T MEHHj]>KMT>HTB yCJIOBHJITA HA HKOHOMHHECKA KPH3A:PA34HTAHE HA <1>HHAHCOBHTE OTMETH ............................................................... 193
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MapiiH POXOBB, BOHIO MHTCB, 3APABHATA CHCTEMA B E'bJlEAPHJIH BJIHJIHHETO HA HKOHOMH4ECKATA KPH3A .................................................... 207
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CT,00Tni£OBa, OTPA>KEHHE HA AEMOEPAO>CKATA KPH3ABT>PXyBMCllIETOOBPA30BAHHE ............................................................................ 229
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MAPKETHHF H VnPABJIEHIIE
FHHKB MH-iiesa, Tamma KyprcBa, ERP CHCTEMHTEH ynPABJIEHHETO HA OHPMHTE B VCJTOBHflTAHA HKOHOMHHECKA HECTABHJ1HOCT 272
Bnpa C-ianHHCKa, OTHOCHO n/lAHHPAHETOHA TOBEtlJKHTE PECVPCH B HPOEKTA 281
3jiariiHa KapaawoBa, HJIAUHPAHE H ynPABJTEHHEHA TVPHCTH4ECKH HPEflnpHflTHil HPH KPH3HCHH CHTVAUHH 285
ECY MesKaynap oxiia KofujtepeHKiifl - 2010
3£PABHATA CHCTEMA B EKJIFAPHJI H BJIHflHHETOHA HKOHOMH^ECKATA KPH3A
rji. ac. MapifH Poxoea, ac. Eoii'io MIITCBHV-Bapiia
THE HEALTH SYSTEM IN BULGARIA AND THE IMPACTOF THE ECONOMIC CRISIS
Maria Roliova, Boncho Mitev
Abstract: The health system is tig/illy connected with the national economy and thepopulation'.? health status depends in great extent on the social-economic factors. Thepaper's aim is to reveal the initial effects of the crisis an the health system in Bulgaria,mainly connected with its financial aspects. Some financial indicators of the system beforeand after the beginning of the economic crisis are examined.
Key words: health system, economic crisis, financing, health expenditures.
- 33 iiKoiioMiiieCKtrre UUKVIJI, j .ipamiH i c CHCTCMHcbcroflHue na
BpisKara Meayiy CHCronmfeTO na HamiOHajiHaTa ffKOHOMiiKa mi eana utp^aBa if(JiyHKUHOHUpaHero wa Hefifmra sjipasna cHcrewa e aoSpe no3H8Ta. HKOHOMH'IGCKOTO pa3-BHTHB OKaasa miHxme Btpxy 3,apaBeoria3BaneTo npaKO - 'ipe3 paaHMmero na cfwffaHcifpaHeHa ctfcreMara tf KOCBCHO - Hpe3 ycJioBiwra HB JKHBOT, KOHTO B.ifiaflT Bi>pxy 3jjpaBoc;ioBHorocbCTOflHHe na HacejienHCTO. Or apyra crpana pesyjfraTMTe or (JiyHKUHOHUpaHSTO na 3jrpaB-nara citcreMa HM3T 3H3HeHMe sa BT>3npoji3BOflCTBOTO Ha HoeeufKUH <j)aK'rop - paooTHaracifjva, a cawara CHcreMa cwaasa aHaHUH aflJi or opyTHfia BtTpemeff npoziyirr (BBH), ocury-p»Ba saerocT n BJiifne Bipxy pasBHTifero na peflifua cstpsaHn ceKropn KBTO c|iap .\taue BTH'I-m HiiflycTpiw, MeflnUHHcKa rexfiiiKa, 3^pa0Ho ociirypaeaHe [2], FIopajiH rosa. »ant^Ho ec-TecTBeHO HKDHOMii'iecKHTe tf.MK.in BT,3fleifCTBaT H Btpxy 3flpa5eona3BaHero - B nojKMOiTe-jien HJIH B orpHifarejieH acnehT.
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npemiaraHeTo H ThpcgHero Ha sjipaBHH ycjiyrH [3]. Cnaavr na EBF1 OOIIKHOBCHO e ci-ripoBoaeH c peuieHHfl sa HaMajtaeaHe Ha pasxoaHTe, or^c^aHH 33 supaBeonaJBawe, icoeTO Hape^c HaMajieffiiero na nocrbmieHMJiTa or 3^ipaBHOocHrypHTe/fHH BHOCKH BO^H Haif-Hecro aoorpaHMHaaaHe na yoiyrHre, (JiHHaHCHpaHf) or nyo^HKHH HsroKHitutf. Karo cnejicTBifsi or no-HHCKOTO paannine Ha iJ)MHaHcnpaHe Morat aa ce nocofar ome orpaHH'faBawe na jiocrbna Ha
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HapacTBaHCTo Ha 6e3pa6oTHfiaTa ca CB-bp33HH c no-BHcoKara o6pautaeMOCT Ha
207
ECY - 2010
KIM nySflHHHiM ceKTOp. ChmeBpeMCHHO BJiomeHMTe ycjiOBim Ha /KHBOT H CTpecoreHmneij)aKTOpn yBejiii'iasaT aaSoJieBaeMocrra n noTpeonocTHTe or 3£paBmi yc-Jiyrn.
OocaeaCTBuaTa or HKOHOMii'iecKirre npn3H uiipxy 3flpaBOCHOBHOTO CLCToaHiie naHacejieiiHero Morar Jia StaaT pa3rjie)KflaHH B KpaTFcocponeH H B aturocpo'ien n;ian [10].KpaTKOCpo'iHHTe e(]jeKTM ce naojiEoaaBaT B pasjiiiinn IIOCOKII M Baptipar OT iiaMaiiHBaHe HasaSojiaaannflTa, CBtpsami c TroriOHOnyuieHe. ynorpeSa Ha aiiKOXOJi. K3KTO H Ha nvrHo-TpancnopTHHTe HHunaeHTH, no HapacTBane Ha caMoySHHCTBara, c-bpae^Ho-ctnosHTe HncHXH'iHHTe saGojiHBaHiis. B jniJirocipoHcn nnat\ ooa'ie eitieKTMre OT HKOHOMH'iecKara Kpca no^HepTano neraTiiBHii, ocoocno 3a no-6eaHitre npocnoiiKii OT Hace^eniiCTO. Te ca3aHii c ne3jipaBOC.noBHiia HBHIIH na JKHBOT - Moaejm Ha xpaneHe, xiirneHHH ycjiOBHfl H corpaHH'ieHiia flOCTbn no snpaBHn ycjiym. OCBCH TOBB 'tecro no Bpewe Ha Kpina BapamiaranpocjjiuiaKTiiKa ocraBa iia 3aaen nnaH. Koero flornj.niiiTejiHO .,nojc(iJiBa" e(()eKTa Btpxy 3^p-3BOMOBHOTO CbCTOflHlie.
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Ha sapaBSTo na HamiMTa - He e noCTiirHaTa 33 cera,Bee ouie e Tatpae pano Jia ce ycTanosaT HaKaKBii noc.ienniiH OT nacToamaTa HKOHO-
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npoiiSTH'iamn OT nero npoS.ieMii. LJejiTa na jiOKJia.ia e aa ce pa^KpiiaT nipBOHa^an-HHTC etpeKTH iia Kpusara si,pxy sapasnaTa cncTewa B Bi>JirapHH, cBtpsaHM OCHOBHO c(|)tinaHCOBiiTe acneimi. H3tioji3BaHii ca MaTepiiaiiH na HautioHaJiKKH CTarncTMHecKH IIHCTM-Tyr (HCH), MHHHCTCPCTBO na (pmiaiiciiTe, MiiHiicTepcrBO na sapaBeonajaaHeio (M3).Hauiiona^HaTa aapaBHOOCHrypiiTe.nHa Kaca (H3OK), CseTOBHaTa aflpauna opraHinaiuia(C3O) 11 op.
aciieicrii na 3jipaBH3Ta cucreMa B Eijirapim ao 2009 r.
B npoflb^^eHiie na no'mi ^Be aeceTMJieTna HenpecTanno ce KOMenjupa (j)iii[aHcnpa-H6TO Ha 3,npaaHaTa CMCTCMa B B-hJirapiiH. Eami OT Haii-'iecrirre oueiiKii ca, 'ie cpejiCTaaTa caKpafiiio HeaocTarh'iHH 3a HOpManHOTO (JiyHKUHOHMpane na cHcreMara.
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a, nocTbnBaimi B cucTeMaTa, KO^KOTO na TJJXHOTO pasnpe^eacmfe u33 nepno^aoT 1999 (rojiiinaTa, B KOJITO 3ano'iB3T aa cc CLOiipaT3zipaBHoocnrypii-
TCJIHH BHOCKII) zio 2008 r. noKassaT, lie o6mnTC pasxojiii 33 3jipaBeona3BaHe HapacTBaT Haj3,5 m,TH - OT 1 320.5 Ha 4 665,8 MJIH. JIB, /I^P11 KOpiinipanii c roamuHna TCMH na HHipjra-UHJI B ceKTOpa. eiKeroano pasxoanTe 33 3#paBeona3B3He ce yaejuiiaBaT MKKfly 5 n 40%.ToBa H3pacTBane 3
ECY Me/Kay napofliia Koii<pepcmum - 2010
1999 2000 2001 2002 2003 2004 20(15 2006 2007 2008
— •— BBO (i)— s — OCniH pasxoaHaa sapaoeonaiBaEie (!)— * — Etojixtr "SupaBeonaiBBiie" (i)••••X' • Pajxoaii na aoMaraiEicTBaTa ja iipaBeonaaBniie (i)
Our. 1. Ba3Hcnn HHASKCH natiRn n pmo/iiiTe sasjipaBeonaamme, 1 999= 1,00 [7]
TCMR na napaciBane na ny5jiniiHHTe pasxonn cnpswo 5BFI (oco-6eHo Mewjiy 2001 H 2007 r.) ce AUDKH npeaiiMHO Ha yse^H'ieHneTO Ha aejivr OT BBIl,OTflejiaH sa 3flpaaeona3BaHe (raSji. I). C^efl 1999 r. H3OK nocreneHHO ce npeBptiiia B oc-HOBCH H3TO4HHK Ha 4»iHaHcnpaHe, KaTO npes 2008 r. fle^tT !ia pasxoaHTe 3a 3^paBcona3-aaiie, oTae^aHH no JIIIHIIS Ha 3aAT>Ji>HHTe;moTO sapaaHO otiirj'pflBane, aocTiira 60%,
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Tafiji. 1. Pa3xoAn sa 3flpaseona3Bane -B % or EBFI H CTpyKrypa na pasxoaHTe OT nySjiiiHHii H 'mcTHii HITO'IHHUII
FojiiiHa
1999200020012002200320042005200620072008
OSuiiipasxojul B% OT EBR
5,65,76,57,37,97,68,07,57,37,2
riySjiiiiHiip;n\o,m B% or BBO
3,93,74.04,44,94,74,94,44,34,1
HaCTHHp;i nuaii B% OT BBH
1,72,02,52,92,92,93.13,13,03,1
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69,964,162,461.162.961,461,658,858,957,3
HacTinipaaxoaii K3TO% OT oGlUHTC
30.135,937,638,937,138.638,441,241,142,7
209
ECV - 2010
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OT couture pa3xo,m 33 3npaneona3aane HaS-ro.naM sun ce HspasxojBa 3dH Jipyrn MMimiiHCKK iipoayKTH - Mcsc^y 35 n 39% ($nr. 2), OCHOBHD (J)iiHaHciipaHif OT
Ha jiOMaKHHCTBaTa n easa OKO.IO 1/5 or SroaJKCTa Ha H3OK (sa 2007 r.).O CT.UIHSIT e ^e^tT na pasxoaHre sa 6o.iHH'ina no.Moiu B cncre.\iaTa Ha 3,apaB-
HHTC CMCTKH, HO npii rax ocHOBHHTC n3TO'rmmn Ha (j'lmaHCiipaiie ca H30K. M3 ii O&UHHHTC.Or ofliiiiire pasxoan OKO^O 17% ce mno^sBar 33 4"inancnpaHe im inBLHGojiHii'inaTa rroMomnpw cLOTHoiuemfc 65:35 nyGnii'mir K\,\\ 'UICTHH pa3xoaii. 3a BCHHKIJ ocraHain ^eiiHOcro aciicre.MaTa cc inpasxo^Bar \ie*-^y 5 n 7% OT cpaaeroaTa, or^enaHii 3a 3.npaueona3Baiie, KOCTO eKpaiiHO Heaocrarb'iHo OCOOEHO 33 paJBimie ua npOiJlH/iaKTHimM nporpaMH.
20072003 2004 2005 2006
I G o.i i Hi-lira no.Mom d TIiBtrffinjirniTiia 110.110111 a.'Ietiiijicrna u Mca.Koiic.VMarmiK D Jpyni
<X>nr. 2. CrpyjfO'pa ua pa3xpj(HTe 3a s.ipaBeoiiajeaiie no iianpaB/iemia [9]
210
MeatoyHapojiHa KOin()epei(UiiH - 2010
3a pa3rne)KjiannH 10 rojuiiuen nepiitxa. B 3.ipaBimTa cncreMa a BiJirapua cepejuma npoojieMii, wacT OT Koino ca HenocpejjcTBeno CB-bp33Hii c (|»iH3Hcnpa-
HETO iia cHCTOMaTa, a apynf npon3Tii'iar OT Hee(|)CKTHBHaTa opramisamiH n ctuio ce OTpa-3flnaT Bi,px.y (}iiiHanciipaHero. HaKOit OT Tesn aecpeKTii ca aoope HSBCCTHH n ICCTO KOMCH-
cjiea CTapra na supaBHOTO ocHrypfmaue CTaHa acno, <<e OKO.IO 1 MJIH.StJirapii lie ce ociirypaBaT. Cnope.T SaKOna 33 3flpaBHOTO ociirypaaaHe TO e33 BcniKii rpavKflaHH B iiamara c'lpana, HO peaJiHO HHKOJIKO FOJIHHH He oaxaMexammiH, c K O H I O jia ce rapanrnpa nim,.iHeHiioTo na 3aKOiia. Aopii n cjinaraKiiBa 6poaT na Heociirypeiiifre BMCCTO aa HaMa^asa, ce yaenH'iaBa-
• pa3xo,iiiTe 3a -lapaseonaiBaHe e/Kero^Ho napacTBaT, HO OCHOBHO 33 CMCTKa Hapa3xojiHTe na flOMaKHHCTBara. BIICOKHST Jjui Ha 'lacrimre pasxojin cc cstpsBa cc flocn,na flo MpasHii ycjiyrn n iiapyniaBaiie na npiiHuimiiTe na co.iiiMpHocrra 11nocTaBeiiocTra. Tosa B rojiaMa CTCIICH Baacn 3a xopaTa c no-HHCKn JIOXOJIH. KOMTO na npaK-
Morar aa ocranaT ,,n3K.iiO'ieHn" OT 3apaBH3T3 CHCTCMQ. CimeBpCMeHHo yiacTiiero HaBT.B 4iiiHaHciipaneTO na ciiCTGMaTa naMajiasa.
.iiipcKTHiiTe njiaiuaniia or naujieHTiire ce yBe.HHHauat, aoKajo aoSposo^HOTOoCJirypHBane see ome ocraisa HepaiBiiro - 'ipes »ero ce ociirypasaT no/[ 1% OT
3ii 3/jpaBeona3Banc [JJ. Pea,riHo [JtHHSHcOBaTa TC*'CCT ce npexBtp.na nee noae'ieKBM QiOflSKeTirre Ha aoMaKiiHCTBaTa, 6e3 3a ce pa3npe^ejia piiCKa H Ge3 ,ia ce ocnrypaT BL3-HOJKHOCTH aa KOHTpo.n Ha paaxoflHic n Ka'iecTBOTO na s.ipaBHiiTC yc.qyrH.
• cTiiuecTBVBaT peainia npooJiewn B opraHHsaunara na s^paBHaTa cucTewa,KOHTO BoaaT no (j)iiHancnpaHe na neerijeKritBuii cTpyKiypn (npeaiiMno ne'ieSini aaBejieiiufl
a noMom). JlmiCBaTOoa'ie peaJiHii OUCHKH Ha noTpeSHOCTiire Ha Hace^emieTO Manajiio, 01.3 ocnoua na KOIITO aa ce H3Bi.puiif npecrpyKiypHpano na ciiCTCMaTa.
3a oo^nii'ina noMOiu npojvb.T/KaaaT aa napacTBaT, a pesyjiTaTHTe 33 3flpaBOCJiOB-HOTO ci>cTO)!Hne na naceneinie iia npaKTiisa ce BjiouiasaT.
peajiHO ocToriHOCTHBane na 3apaBHHTe ycjiyrn, san.'iaiuaHii OT H30K.
EdieKTii na HKOiiOMH'ieeKara Kpiiia fltpxy sapannaTa ciicreMa B
B Bwirapua HKOHOMHiecKaTa Kpioa ce nposBHaa HO-KI.CHO B cpauneHiie cie erpaHii - m,pBirre cHMmoMH ce yccmar B Kpaa Ha 2008 r. FIpe3 TperoTo TpiiMCce'ine H32008 r. npnpacTLT Ha BBI'I HaMajiMisa OT 7,1% na 6,8% i ; .oocTiira JO 3.5% npes 'leTB-hproTOrpiiMece'iiic Ha ro^iinaTa. 3a nepiioaa anyapn - wapr 2009 r. 33 ni^pun DT,T OT 1998 eoTieieH cnaji c 3,5% cnpaMO ntpaoio Tpimeceiiie na npeaxounaTa roaiina. Flpe3 2009 r.EBFI HaMa.i3Ba c 5% cnpamo 2008 r., KBTO Ta3ii TenaeHUHH ce sana^Ba 11 npe3 m,pBOTO
na 2010 r.. Maxap n c HO-HHCLK rewn, FIpe3 ciuiaTa roaiiHa ce nadnroaaBa nptcT B paBHiimcTo Ha 6e3pa6oTimaTa a Bi^rapHa (OT 6,27% npe3
2008 r, Ha9J3%iipe^,T.eKeMBpii 2009 r. no nanmi na MnmicTepCTBOTO na sBcii'iKO TOBa ce OTpasasa iieraTiisiio Btpxy paBHniiiero na tjiiiHaHcupaHe Ha sapaa-
Hara CHCTCMB OT nyojni'mii inTO'mimii. 3a TOBB cBiiiierejiCTBa HeiniibJiHeHiieTO naTa Ha H30K 33 2009 r. KaKTo B npiixo^Hara, TBKB H B pa3XoanaTa \iy qacr. OTnpnxo.au npei roannaTa ca ci,GpaHii exlBa 89,3%, a pa3XomiTe ca 84,6% OTBiiecTO 3aniicaHiia B DKxaaeTa H3Jiiiuii,K OT 401 MJIH. JIB. B pesepBa Ha H3OK ca455,4 MJIH. .nu., KBTO cimespeMeHHo ce Hao.nroaaua 3a6aBnne B njiamaHHHTa Ha ijiiiTe Ha 3^paBHii yc^yrH OT cTpaHa na Kacara, KOCTO 3aTpyaH3Ba flom-jmnTejiHo jefiHociraHa .le'ieSHHTe 3aBeaeii!is.
211
Me/KayHapoaHa KoucI icpcHunn - 2010
Opes 2009 r. ce Ha6mo^ana 3HaMiiTejiHO napacTBaHe HanpHXO.au, B cjiejiCTBiic Ha ynejinHeH3Ta 3jipaBHoocnrypMTejTH3 SHOCKS or 6% Ha 8%, KceroflorrwiHiiTejiHo BO^II no ysejiii'teHne na piuxofliire na JioMaKHHCTBaTa 33
Hpe3 2010 r. 3ano4Ba o.a ce npoBOK/ia CHJIHO pecrpiiKTHRira nojnmiKa noHHe na oiojWieTHHTe pasxojui Ha AipwaBaTa. Toea ce oTpassBa t i mpxy 610.1̂ (613 Ha H30K,B KoiiTO pasxojHara nacT e cbiuecTBeno orpami'teira (Taon. 2). rijTamamiaTa KT.M aocTas'iu-UHTC na 3apai3HH ycnyrH HaMajisaar c OKCWIO 16% cnpaMO npeflXOflHara roaitua, Karo Haii-3iiaH»MO ce ciKpamaaar pasxoziiiTe aa SojTHii'ina noMoiii (c 3 1% cnpHMO 2009 r.). Karo oc-HOSHa npHKHiia sa TOBa ce noco4Ba C!3pTjX\octTHTaji!i3aunaTa na Hace.ieHiicro 11 HeeiJ)eKTHB-HOTO pasxoauane Ha OKWKeTHiire cpeacTaa, a HHCTPXMCHT sa cnpaBJiHe c TOSH npoojieM eBTiBewaaneTo Ha ciicreMaTa Ha aejierupaHHTe SIOJIWCTH.
B ctiuoTo apeMe Syaii nefloyMCHHe (jjaKra, 'ie e 3ajTo>Ken Sioa^eTeH USIMWLK B pas-Mep na OKOJIO 839 M^H. JIB., KOCTO npeflcraB^flBa jieyKpaTHO yBe.mqeHHe Hacpe^cTBa na Kacara B EHB B cpasneHiie c 2009 r. (736/1. 2). Ho TOBH Ha<mu ceBii3MO>KHOCTiiTe 33 ii3no^3BaHe wa MexaHioMif 3a no-e(f)eKTHBHa (|)HHaHCODa nojiHTHKa HaH3OK. /[o n3RecTH3 crenew noaueHenara pssxojma 4acT Ha Oioflwera ce Kopnrnpa BcpeaaTa Ha roflHHara c HeroBara aKTysjiusauifa, npii KOHTO ce npeflBiiwza yBe^ii'iaBane nanjiamanmna 33 GojiHiiHHa noMOui c 178 M^H. JIB.
Tafiji. 2. npiixojiii H pasxojii Ha H30K ia nepiio^a 2008 - 2010 r. [4, 5, 6|
3,apaB HOOCH ryp')TejIH!l npnxoaii (B MJIH. JIB.)HsMeneuiie (reKyma/HpcjixoaHS rojiiuia B %)3jipaaHoocnrypHTejiHH pasxo^H (B MJIH. .IB.)HsMCHenHe (reKyma/npc^xofliia i u . i i i i rs i B %),fle(])U[IHT / H3J1HU1LK (+/- MJIH..1B}
Pasxo/iH sa 3flpaBHoocnrypnrej]HH miamaHiifr, orTHX:M iiH'iH'iinc (TeKyiua/iipe^xoana ro/iima B %)PasXOflH 33 rifcpBH'IHaZlODOJlHliHHS HOMOW-
OFIJI (B MJIH. JIB.)l i j M c i K ' i u i c (TeKyma/npeaxoaHa roJjuna B %)Paaxoaif 3a /io6o,'TH(i4ira CJieilnajTH3iipaHa tioMOiii(B MJIH, JJQ.)HsMeHemje (TCKyiua/npejixoana rojinita B %)PasxoflH 3a aCHTajiHa noMom (B MJIH. JIB.)HiMeiiemie (TeKyma/npczixofliia rojHna B %)P33XOJ4H 33 MCflHKO-JI»arUOCTM'lHajiefiHOCT(B
MJ1H. JIB.)
HsMeHeHiieJreicyiua/npCJixojjiHa roflima B %)PaaxoflH sa JTCKapcTBa 33 jioMamno Jie'iemte,MejjHUHiicKH n3ZiejiiiH H fliieTii'iiiii xpaHH (B MJIH. JIB.)
H3MeHeiine(TeKyma/npejjxoaHa rojnma B %)3apaBHOocHrypnTejiHH njiamaiiifa 3a SOJIHHUH (BMJIH. JIB.)
njMCfic in i t 1 (TeKyma/npeaxojiHa ronmia B %)OnepsTHBCH peaepa 33 nenpeaBiiaeHH HHeOTJIOWHIl P33XOJIH <B MJIH. JIB.)
HaMciieHne (reKvma/npe;j\oana rojjjiMa B %)
2008 r.1 686117+39,08
I 686 117+8,71
-14S6390
+6,49125 945
+8,62136 162
+17,2267516+9,7555621
-295 490
+4,73785 575
+3,04143 854
+21,30
2009 r.2 472 943
+46,662071 182
+22,83+401 7611 746 423
+17,49157 000
+24,66154800
+13,6991363+35,326T828 1
+11,16330 000
+11,68931432
+18,57240 249
+67,01 '
2010 r.2519211
+18,711 689 432
-22,60+829 7791511932
-15,51157000
-154 000
~^52 '91000-0,40
61000
-1,36320 000
-3,13708 932
-31,39125 058
-92,11
212
IECV Me/Kayaaposaa KOHJJIC/K'UHIUI - 2010
J]pyr npoSjieM ce oKaaaa nenpem>CHaTo yBeiwiasaiiiHsr ee Spofi jmua c3JipaBHOociirypifTe.'7HJf npasa. l~Io jiaHHii OT nepconajiHua penicrbp Ha HOH KT>M01.01.2008 r. Te\nn3T 6pofi e 991 XHJI, zywa, a B cpejiara Ha 2009 r. - eeie 1 026 XHJI.ayuiH. C npoMewiTe B Basona sa sapaBHOTo ociifypseaHe, c Kofrro ce yBemnaBa cpoKvr 33no.i3BBne ua npaaa no jaSbn/KirremioTO 3apaBHO ociirypsaaHe Ha 33 MeceiHH BHOCKH orfiocjfejmnre 36 meceua, HeociirypemiTe Jinua ca c 380 XH/T. ayiuw noeete [I], Karo Bcpcaara jia 2010 r. TCXHHST Spoil cnopea p33JinHHn HSTOHHHUH ce flBH»cn weway 1 400 H J800 XHJI. nyuitt. OcaeH npoMSHara B jaxona, jipyr (pato-op, Koilro o«a3B3 BJIHSHHC, e ysejiM-
Ha 6poa na 6e3pa6oTHHTe.HeGnaronpiiHTiiara TeiwenuHara B pa^xofliire na flo^^aKlIHCTflaTa, or^enaHH 33 3np-
e, ce 3ana3oa, flpes 2009 r., KaKTO if npe3 ntpBoro Tpu.Mece'iue ua 2010 r.cpe/icTBara we ca.Mo, 'ie HapacTBar Kara aScoiiioTHH CTofinocTH, HO ce yBejiifiaea 11 aejrbTHM B oSui'ftf Gionxer Ha aoMaKifHCTBara - OT 4,8% npe3 200S r. Ha 5,3% npes 2009 r. H 0.0-CTiira 6,3% B nafajfOTO na 2010 r. [8]. G yc.ioBHSTa ua HaMajiaeamif aoxoaw Ha uacejieiiHe-TO nojioSHo yBejjii'ienne Ha pasxojufre aa ^oMaKiiHctBaTa MOJKC us ziofie^e ^o 3a5aBHne Hajie'iemte » B Kpafina cAieiKa BnoiiiaBane na 3apaBOCJIOBHOTO ctcToaime. OpcS/ie^vr e oco-IJeHO Cepff03CH 33 XpOHHIHO 6OJIH(fTC fiaUHCHTH.
C3O np»3oBa AS He ce naMajfsfBar paaxo^HTC 3a i^paseonasQaHe, o5pa30B3Hiie Hcouifajvjfa sauiHTa, Tbii Kara "npeamBfiKarejicTBOTO npe^ cacTa cera e jia Hanpaau BCMIKOBL3MOJKHO HKOHO.\fH4ecKaTa Kplt33 H3 HC HpCpaCHG B COUlta/fHa If 3iIpaBH3 KpH3a" [II]. 3a
ciwaJieFiiie, no^KTHKara, npeanpnera OT npaBitTejicTsoro npea 2010 r., cjieaaa TOHHO 06-paTiiara ^orfiKa - ctmecTBeno orpaHifiaaaHe Ha pa3XoawTe H aanarane Ha 3HaqoTe^eH H3-jiiiiuiiK B tjioji/fceTa HH H30K. FIoa^epTaHO pecTpHKTiimiara nojiHTHKa na nyS^HIHHre paa-xoan 33 3zipaBeona3GaHe onpeaejieHO He e npaBHJiHaTa nocoKa B KOHTCKcra ua 11 6e3 Tosayeejiii'iaaamaTa ce (j)llHaHCOBa TewtecT 33 aoMaKHHCTBara, ctf eTana c HawansBaHe Ha aoxo-nine ii HapacTBaiie ua SespaSonmaTa B ycjioaMSTa na nKonoMH4ecKa Kpusa.
rh.pBnre ciirfiMii 33 HeraTHBHOTo oTpa/KCHite na Kpimra eiipxy 3flpaBHara CKCTCMHB HaiiiaTa crpana ee'ie ca Hajiime, a rosa c rojisMa BepoarHocr me ce orpa3H n Btpxy 3^pa-BocjioBHOTo ctcTOflHiie Ha HaceJieHiiero, HMGHHO nopaaif rosa e Heo6xo/m.\io cneuiHo na cenpeanpHewar wepKH, KOHTO j& oTCTpaHST fiaTpynaniiTe ae^ejcm B cHCTewaTa 11 ua no-Bifuiar Hcilnata e(peKT(iBHocT.
EJIHO OT nail-BawHiiTe petiieHiffl aa citCTewaTa c pa3paoorsaHe Ha noaa HauHOHa.iHa3npaBHa icapTa, KOHTO ^a ce ocHoaaea ua aaeKsaTHa H 3aat.i6oieHa oueHKa Ha 3/ipaBHHTei!OTpe6HocTif fi najiHiHHTe pecypcii » Ha Sasa ua rtma ^a ce onpeae/iflT oposT H BHHT,T naHeo6,\oj]jiMHTe SO/IHHUH, KBICTO H TCSH, KOHTO TpsGea jia ce npeoopasysar B ApyntsaBe^eHiia ti^if aa ce 3aKpHST. OnifTbT n.& ce cbKpauiaBar SOJIHHUH 4pesiw?H HKOHOMii'iecKa npHHyjja ti cjieasailKH ripasimoTo ,,KOifro oue^ee" onpejie^eHo we e
MapKa B ycjiOBHflTa Ha Kpnsa H HecTagiuiHa 3flpaBHa cHCteMa. TapaHTiipaHero najjocn.fi Ha HacejiemieTO no MeaummcKa noMom TpaQea .aa ocraHe oCHoeeH ripn-
opiiTer, K3TO iiapea c TOB3 e HeoSxojiHMO fla ce TtpcttT HaiiHnn 33 noBHiuaBaHe Kafcro uaHKOHOMH4eCK3Ta eipeKTHBHOCT, T3K3 H H3 KafCCTBOTO Ha 3^p3BHHTe yCJlJTH.
3a jia ce orpami'iaT HeSjiaronpjfsTHitTe nocjie^cTBus stpxy 3/ipaBeTo, o6aie,lencTscHara nojTiiraKa Tpaoaa aa 6i>&e Haco'iefia H KIM passHTue Ha counauHH HnporpaMH, opMCHTiipafiH KT>M HywaaeuiHre ce H rapanrifpaHe H3 cpe^cTsara,
33 npo<})j)JiaKTiiKa H npoMoiwji
213
ECy Me/KflynapoflHa KOKiJiepeHiiiin - 2010• • -j»^
JIiiTeparypa:
1. BiiTKOBa, M. 3flpaBHOocnrypHTejiHiiHT Moaeji - 06111 npoG/iem ripen. HHCTtnyuiijrre,KOMnamiHTe H nauneHTHTe B E-b/rrapna. ROKJIZJI Ha KombepeHiwa ,,3ilpaaHOTOocurypaBaHe B Ei-impim - cicTonmie H nepciieKTHnn". Coijiiin, 26.01.2010;hl(p://health.insurance,bg^presentations/Mim i_Vi tkova.pdf.
2. fleji'iefia, E. HpoyiBaHe etpxy e^eKTiiDKOCTTa Ha 3,ipaBHiiTC CHCTCMH B tier crpaHli orlOroifSTOHHa Espona. Cn. MffOHOMii iecKif EuiTepnaTHBH, 6p. 1, 2008.
3. EBponeiicKa KOMHCHH. COM(2010)25. FTpejiJio/KeHHe 33 CBBMCCTHHH flOK^aa OTHOCHOcoiuiajiHaia saKpuna u counanHOTO npno6iiiaBaHe 2010 r. EpioKcen, 05.02.2010.
4. 3aKOii 3a 6iofl)KeTa Ha H30K 33 2008 r. flB. 6p. 113 or 28.12.2007 r.5. 3aKOH 33 SJOffiKCTa wa H3OK 3a 2009 r, AB. 5p. 109 or 23.12.2008 r.6. Saxon 3a 6ioa«eTa Ha H3OK 33 2010 r. RB, 6p. 99 OT 15.12.2009 r.7. OCHOBHH MaKpoifKoiioMti'iecKif noKa3aTejii{. HCH, C., 2000-2009.8. HCH. floxoflH H pasxo^H Ha aoMaKHHCTBara. [npo'ieren Ha 10.06,2010 r.]
http:/Av\vw.nsi.bg/ORPDOCS/HH_2.1.3.xis.9. HCH. CiiCTCMa na sapaBHM CMCTKH. [nponereHO Ha 2.06.2010]
http://www.nsi.bg/otrasal,php?otr=22&al=509&32=l058#cont.10. Buziarsist, J. Economic crisis on public health. Arch Public Health, 67, 2009,11. WHO. The financial crisis and global health. Report of a high-level consultation.
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