Public healthcare in Romania is provided free at the point of need through a national health insurance scheme. Contributions are compulsory, with voluntary top ups, and are paid by both employers and employees. The statutory health insurance system was established in 1990. General and oral health care depends on the compulsory membership of each insured citizen in the Social Health Insurance System. The National Social Health Insurance House (NSHIH) at national level and County Social Health Insurance House (CSHIH) at county and capital level administrate the system. The whole population is insured and pays monthly a fixed amount of their salaries to the CSHIH, situated in the county where they live. The system of social health insurance provides a legally prescribed standard package of general and oral healthcare.
In response to the poor quality of state provision, private healthcare has been growing rapidly, with a number of providers bypassing the state system altogether and building their own private hospitals and clinics in major cities such as Bucharest, Constanta, Brasov, Cluj. These hospitals provide treatment that is paid for directly by the patient and is unlikely to be covered by the national health insurance schemes.
Since 2000, several high profile, top quality clinics and private hospitals have been built, being mainly locate in the main city Bucharest.
With government backing and strong investment from international private healthcare providers, Romania is rapidly becoming an important destination for healthcare tourism in Europe, offering that ideal combination of high quality care and low, affordable prices.
Private health insurance companies are started since few years and cover partially general and dental treatment. They are mainly sponsored by the main multinational companies, as part of their employee benefit programs.
The Quality of Dental Care
Specialists are widely used. Continuous education for dentists is mandatory, and is administered by the Romanian Collegiums of Dental Physicians (RCDP), to which all dentists must belong.
A mixed commission (CSHIH and the Romanian Collegiums of Dental Physicians), only following a complaint of a patient, can judge the quality of work in the NSHIH system.
Outside the NSHIH, in the liberal system, the quality of dental work can be judged only by the RCDP. From the quality point of view, the County Social Health Insurance House has the right to control regularly the activities of dentists who have a contract with them, through an inspection commission composed of employees of the CSHIH, which may or may not have dentist members.
Almost 90% of dentists are private; they have fiscal code and all needed legal authorizations for free practice, with full responsibilities. Almost half of Romanian dentists, owners or non-owners of their dental offices, work within the CSHIH. The other half of the dentists work in a completely liberal (private) system, with direct payments from patients only. The number of CSHIH dentists is limited by the Social Health Insurance Houses at county level.
Private dental care
A large number of dentists have only private patients, who pay the total cost of care. Private fees are regulated by the internal rules of every dental office and generally they are established after a direct negotiation between the dentist and his patient. A real free dental market was established after 1990, with prices regulated by the principles of the market economy.
CSIH- County Social Health Insurance House
RCDP- Romanian Collegiums of Dental Physicians
NSHIH- National Social Health Insurance House