Can people afford to pay for health care? New evidence on financial protection in the Republic of Moldova (2020)

By Iuliana Garam, Mariana Zadnipru, Valeriu Doronin, Andrei Matei, Ilaria Mosca
2020, xiv+ 80 pages
ISBN 978 92 890 5428 0
This publication is only available online.

This review is part of a series of country-based studies generating new evidence on financial protection in health systems in Europe. Financial protection is central to universal health coverage and a core dimension of health system performance.

The Republic of Moldova has demonstrated strong commitment to universal health coverage through reforms aimed at improving the accessibility, affordability and quality of publicly financed health services. This has led to greater use of health services and fewer people reporting unmet need due to cost. However, persistent gaps in coverage and other factors undermine financial protection for people using health services, increasing their exposure to out-of-pocket payments, particularly for medicines.

To strengthen financial protection, the health system should:

• change the basis for entitlement to health insurance fund benefits to residence, rather than continuing with entitlement based on payment of contributions, which offers no advantages and involves additional costs;
• extend the range of essential outpatient medicines covered and at the same time introduce exemptions from co-payments for poor households and regular users of health care;
• address inefficiencies in the procurement, pricing, prescribing and dispensing of outpatient medicines;
• ensure that growth in public spending on health not only matches economic growth but also results in steady year-on-year increases.