Moldova Medical Insurance
Moldova, officially known as the Republic of Moldova, is a landlocked country on the Eastern European continent. It is bordered by Romania to the west and the Ukraine to the north, east and south. Moldova became an independent state after the dissolution of the Soviet Union in 1991. The government is now a democracy where the president is the head of state and the state is run as a parliamentary republic. Moldova has an estimated population of 4.3 million people are dispersed over a landmass of 33,846 square kilometres. The official language is Moldovan (Romanian) with Gagauz, Russian and Ukrainian being spoken in certain areas. The capital city is Chisinau.
In 2008, 74 percent of GDP revenue was generated by the services sector, with industry and agriculture representing 14.7 and 10.9 percent respectively. This was a dramatic change in comparison to 1989 figures when services represented 24.3 percent, industry 39.2 percent and agriculture 36.5 percent. The European Parliament considers Moldova to be one of the poorest countries in Europe in terms of GDP.
The health care system inherited from the Soviet Union underwent major reform after independence in 1991, but due to a severe lack of funding the national vaccination program came to a near stand still, facilities and equipment became outdated and the supply of basic drugs and contraceptive devices was inadequate. Primary health care and preventative health care to this day remain under-resourced with 85 percent of funding coming from international donors. In 2000 there were 40 regional hospitals and 40 sector hospitals that received 70 percent of the total funding provided to the health care. The majority of this money was spent on improving the physical infrastructure of hospitals while neglecting medical equipment, pharmaceuticals, and treatment and staff salaries.
The Minister of Health, under the new reform has overall responsibility for national-level tertiary care facilities, the state hospitals and coordination of special national level programmes. The total public expenditure on health as a percentage of GDP was 5.25 percent in 2007. The health care system is funded from three main sources: general taxation, regional taxation and direct private funding. In 1995 the Basic Law on Health Care was passed making provisions for private health care. As a result of this law 54 percent of outpatient health care facilities and 6 percent of hospitals in Moldova are now fully private. Dental surgeries and pharmacies are almost all private. A further law on health care passed in 1999 sanctioned hospitals to generate income from additional sources other then national and local budgets.
Article 36 of the Republic of Moldova Constitution guarantees the minimum provision of health care services should be provided free of charge to the population. However, government funding fails to meet this minimum requirement resulting in patients paying for health services themselves out-of-pocket. The World Bank estimates that the contribution of individuals through direct payments for health care in Moldova is on par with government funding to the health care system. This has had a direct impact on equity of access to service.
Primary health care services are delivered at a local level by health posts, family doctor offices, health centres and family doctor centres linked to local level hospitals. There is a regional hospital operating in each region with state level institutes providing specialised care, these institutes are mainly based in Chisinau. In 2000 there were 36 family doctor centres, 366 health centres and 441 general practitioners with the rural population receiving additional first aid by means of 585 doctor’s assistant health posts. The Ministry of Health funded 189 of these facilities compared with 294 by private enterprises. A survey undertaken by UNICEF found that 71.7 percent of patients in one district believed that the primary care services had worsened over the last years in spite of restructuring reforms.
The Ministry of health is involved in a number of health promotion programs concerning tuberculosis control, prevention of viral hepatitis, diarrhoeal disease and cholera, anti-rabies programmes and iodine deficiency disorder prevention. There are environmental health concerns due to the high levels of pesticides and fertilizer used in agriculture.
Secondary medical care services such as ambulance services and basic hospital care and tertiary care such as specialised medical services underwent restructuring in 1999 to reduce costs with the view of investing the savings in the provisioning of primary care. The plan proposed that only one regional hospital would remain operational in each region. However, in Chisinau, specialist care facilities remain high with up to fifteen municipal hospitals and nine specialist centres in operation.
The Ministry for Health defines the price of medical care services in Moldova. Any services that are not included in the minimum provision of health care decree are financed by private health insurance companies, patients themselves or enterprises. If you are not a resident of Moldova then comprehensive Moldova medical insurance is required to avoid paying for services out of pocket.
The estimated birth rate for 2011 is 11.6 births per 1,000 people, while the infant mortality rate is 12.43 per 1,000 live births. The life expectancy at birth for males is 67.68 years old and 75.28 for females. The total number of people living with HIV/AIDS is estimated at 12,000, ranking Moldova as the 77th worst affected country in comparison to the rest of the world. In 2009 an estimated 26.3 percent of the population lived below the international poverty line. The major causes of morality in Moldova are cancer, respiratory diseases, cardiovascular disease and accidents. Alcohol consumption and illnesses resulting form the use of herbicides and pesticides cause extensive health care problems.
The crime rate in Moldova is high with street crime, bag snatchers, pickpockets and petty theft being a particularly serious problem in Chisinau. There has been a sharp increase in ATM fraud; you are advised to avoid using debit or credit cards if at all possible. If you are not registered by the authorities on your entry to the country you most do so within three days of your arrival. Failure to register may result in fines and/or difficulties on your departure from the country. Travel to the north-eastern area of Transnistria is not advised as this area lies outside Moldovan governance. Travellers should be warned that if difficulties with the authorities arise, consular services may be limited in their ability to help. Photographing military or government facilities could lead to problems with the police.
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