Health spending of Bulgarian households is too high and considerably limits the financial protection of all, a World Bank report said here on Tuesday.

In 2012, around 6.3 billion lev (some 4.2 billion U.S. dollars according to the then exchange rate) was spent on health care in Bulgaria, or about eight percent of the gross domestic product, according to the World Bank's final report on health financing diagnostic and review of envisaged reforms.

As much as 47 percent of the total expenditure was out-of-pocket (OOP) costs incurred by patients, and "Bulgaria is thus a considerable distance from meeting the World Health Organization criterion for adequate financial protection, which specifies a ceiling of 15 to 20 percent for OOP payments as a proportion of total health spending," the report said.

Furthermore, the situation has deteriorated markedly, said the report, which was presented at a meeting of the Council Partnership for Health, an advisory body to the Council of Ministers for coordination and cooperation in the development and implementation of policies in the field of public health.

OOP costs in Bulgaria increased by more than 20 percentage points between 1995 and 2012, while countries such as Chile, Mexico, Thailand, and Turkey, which started from a similar or higher base, have made tremendous progress in reducing OOP expenditure, the report said.

"Bulgaria's trend runs counter to the well-established relationship of diminishing private (and OOP) expenditure shares with increasing GDP," the report said.

Meanwhile, household budget surveys in Bulgaria show that the high level of OOP payments considerably limits the financial protection of all, the report said.

"The share of the household budget spent on health is relatively high, at 5.3 percent in 2013, against about 3.0 percent on average in Western Europe," it said. Endit

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