Global Healthcare Systems: Perspectives on Pathology Practices in Bulgaria

Healthcare in Bulgaria is a universal and free right as per legislation. However, due to limited government funding from a singular state-run insurance fund and the inequities in the distribution of limited healthcare professionals, access to quality healthcare is difficult for most citizens. Pathology is one of the most severely affected specialties as it is not only regarded as one of the most difficult ones due to its aspects and difficulties in obtaining it but also due to the lack of funding. The healthcare fund does not reimburse immunohistochemistry or genetic tests; however, hospital reimbursement relies on pathological diagnosis in most cases, prompting peer and institutional pressure towards adapting the diagnosis. A relatively good aspect of all of these is the low cost of immunohistochemistry if the patient chooses to pay for such, albeit when compared to the mean monthly salary within the country, the cost is still high. Lack of funding is not only limited to biopsy diagnosis, with research funding being minimal at best, while autopsy practice receives no funding whatsoever.