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Introduction
Actuality of the topic. Since 1991 the Republic of Moldova made the transition to
market in terms of socio-economic crisis. One of the conditions necessary for normal
functioning of all areas of life in society is to develop and implement practical
methods of regulation and control in health.
Reduction of budgetary resources, lack of material resources and high percentage
of loans made to the budgetary policy of Moldova to be much tougher.
One of the possible ways of restoring the health situation at the present stage is the
implementation of health insurance as a form of activity which requires the
implementation of the health care system of market relations with all laws
characteristic of these relationships.
Because health insurance is aimed at health, it acquire a very pronounced social
aspect.
The current situation in Moldova allows to highlight a number of problems related
to human health and functioning health care system:
½‘ Continuous deterioration of health status;
½‘ ecreased population accessibility to health services;
½‘ ecreased quality of care that patients that does not meet the standards of
modern medical care;
½‘ neffective use of resources allocated to the branch, etc.
The need to further improving the population's access to medical services, requires
a careful study of the evolution of social health insurance system as a whole, its a
permanent correction for the efficiency.
But both the effectiveness and efficiency of health insurance are inevitably
subordinated financial opportunit ies which provide financing system in return as
mentioned previously, the population's health needs.
Working from the insurance market lasting several forms of health insurance is
confirmed to be the most appropriate format for organizing the health system .
Competition occurred in these relationships requires medical institutions to provide
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quality services, determined by practice performance methods of investigation and

treatment, as well as improving the quality and conditions of service.
Health Care Reform is one of the major social changes in Moldova.
Health care insurance is the most progressive and effective current method and has
a wide application in many countries of the world market economy.
With health care reform, shifts to the insurance model of medicine is to achieve
goals including a special place it has higher quality medical services provided
curative and preventive institutions of the Republic of Moldova.
Thus, quality of service provided has become a theme frequently addressed in
socio-economic studies within the industry because it is one of the factors that
positively affects saving and material resources to raise effectiveness of medical
institutions.
xhe aim of the study: to study the health insurance market and developing
technologies to improve organizational quality and volume of health care by health
insurance.
Objectives of the study:
1.‘ ànalysis of the health insurance market in countries that practice mixed type of
health insurance and in Moldova;
2.‘ Studying the possibility of joining the mandatory medical insurance scheme
with voluntary health insurance in the Republic of Moldova;
3.‘ eveloping technologies to increase the quality of organizational and volume
of medical services to insured persons;
xhe originality of this work consists in tackling health care reform by passing the
security model, this creates additional financial resources for health care for the high
quality health services to provide health professional s with a respectable income,
which would meet the quality and social value their work.
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ëhapter I. Place and role of health insurance in the context of social security
1.1. Health insurance and its role on the insurance market.
uring the existence and development of human society, man was preoccupied
with issues related to providing material and financial resources. ntensive
development of society has led to opportunities for human intervention for
preventing or reducing the negative consequences of d amage to generating
phenomena. Of all ways and methods used by humans for the prevention of loss
events, the most suitable was proved to be insurance. From this perspective,
insurance has taken a fairly large scale in countries of the world, becoming, in r ecent
years, a branch of the global and national economy.
àppearance of insurance was determined by need of protecting themselves
against natural disasters, accidents, through the accumulation of livelihood in terms
of loss or limitation of working ability after illness or old age. às the development of
society, have enlarged effective means to limit the loss events and the methods and
ways of ensuring the population. Factors that have led to insurance, are the economic
and social. àmong economic factors, the principal may be nominated:
1.‘ changing economic conditions with the transition from one type to another
type of economy and, correspondingly, the diversification of relations between
people;
2.‘ development of international relations and as a result, the need to guarantee the
goods against risk.
àt present, increase the importance of social factors, among which occupies a
special place:
½‘ intense development of the phenomena of urbanization and, correspondingly,
the population concentration in large cities;
½‘ increased risk of illness and traumare;
½‘ increasing number of factors and events producing damage;
½‘ organization in groups and guild members shall assist each other.
Cultural aspect of social health insurance is deeply rooted in the countries where
they were generated and initially introduced. Germany is considered to be the source
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of this approach to health insurance because she was the first Western European
country which, in 1883, introduced in official state law structures social health
insurance voluntarily. Most researchers in the field agree that the birth of health
insurance in 1883 was signed by German Chancellor Otto von Bismarck, who
introduced the first compulsory social insurance program nationwide, yet its
precursors are more difficult to identify.
The merit of Chancellor Bismarck is one which has created a social insurance
system. n addition to insurance funds, made by contributing of employers and
employees and which were intended to provide financial support not only the cost of
medical care but subsistence workers during the disease a year later was introduced
compulsory insurance against accidents. Operating mechanisms were similar, being
based on contributions, and funds management system employers and employees.
The German example was followed some years later by àustria and taly, as early
twentieth century to be taken in Sweden and the Netherlands.
The economic crisis of the '30s determined even the U.S. government to take a
series of concrete measures in order to create a social se curity system, including
health care, despite constant opposition from business circles, traditionally reluctant
to any state intervention. àfter the Second World War and, especially, by the mid-
70s, the economic growth has also contributed to the developm ent of adequate social
security systems, a process which - along with their diversification - has led to cover
a more significant segment of the population.
Today we can say that the health insurance system is a result of the level of
development and civil ization of the nation. The manner in which this system is
implemented in each country depends on a combination of factors, which may be
mentioned: the level of economic development and socio -cultural, nature programs,
human resource requirements, character istics and evolution of family social life,
traditions, retirement age, reporting to the disease, medical services and benefits.
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Health insurance appeared in order to protect people on their day by day life. àlso
health insurance became an insurance product which provides profit for the
insurance companies on the insurance market.
The current system of social health insurance, almost universal in Western Europe,
is the culmination of a historical process of 700 years. uring this period, the number
of people covered with health insurance grew from a small number of workers from
the trade to all citizens or at least all citizens whose income is below a relatively high
income. Equally important is that the main concept of this form of social insurance
has changed, moving from wage replacement and the death benefit to pay for
outpatient medical services, hospital care and pharmaceuticals. àdministrative nature
of social health insurance has changed over time, starting with voluntary
cooperatives and later, in 1883 in Germany, the Netherlands in 1941 and 1996 in
Switzerland has evolved into a state -legislative.
àfter making mode, there are two forms of insurance: compulsory and voluntary
(optional).
The ©
  
 
 
 , the relationship between the insured and the
insurer, the rights and obligations of each party, terms and conditions for their
implementation are established by law. Relations between the insured and the
insurer, the rights and obligations of each party, terms and conditions for their
implementation are established by law.
Mandatory health insurance is meant to ensure the unique standards (general)
population social protection in health insurance. n Moldova's conditions, this type of
insurance is designed to maintain financial areas t hat fall behind in their socio -
economic development and not have opportunities to independently form the
financial basis for payment of medical services required value. nsurance, as a type
of business, aims to match individual risks between group members and not allowed
to enter the insurance group objects, capable of refocusing the group risk category in
the direction exceeded the average. n social terms, this section is called
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*discrimination*. The essence of insurance, in this case can be expressed by the

words *always a group - never social*.
This limitation manifested commercial insurance, which may be a mechanism for
financing public goods. Therefore, commercial health insurance in Moldova, in our
opinion, may be performed exclusively as voluntary. Voluntary health insurance is
protection to ensure guaranteed supplies for all citizens who are insured by the
individual or collective voluntary insurance of citizens' own account, payments from
the revenues or profit enterprises. However, volume and cost of care and services
offered under such a contract depends on the size of contributions. Size of
contribution, in turn, is determined by the health insurer by each insured or group of
policyholders. n addition, the size depends on the insurance contribu tion rates for
those medical services that are required for the quota given, according to specific
contracts. n this case, the universality of participation is missing, a feature of
compulsory health insurance. The need for compulsory medical insurance is in
Moldova, as the state confirms that the protection of people's health has a crucial
importance for the success of market reforms, stabilization and further development
of society and not having sufficient resources in its budget for this protection, us e for
this purpose compulsory insurance, based on mandatory contributions of employers
and the citizens themselves, funding guaranteed level of health insurance. f,
however, some members of society or some organizations are able to protect health
at a higher level than that guaranteed, then use the voluntary medical insurance.
Compulsory health insurance system is organized and functions having the
following principles:
a)‘ the principle of uniqueness, organizes and ensures that the state compulsory
health insurance system based on the same rules of law;
b)‘ the principle of equality, whereby all participants in the mandatory health
insurance (premium paying compulsory medical insurance, medical service and
medical assistance beneficiaries) are provided with a n on-discriminatory treatment in
respect of rights and obligations under the law;
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c)‘ solidarity principle, under which payers of insurance premiums paid

mandatory healthcare contributions according to income and healthcare benefits
insured as required;
d)‘ mandatory principle according to which natural and legal persons under the
law have the obligation to participate in compulsory health insurance system and
health insurance rights shall be exercised in correlation with the obligations;
e)‘ contributiveness principle according to which the health insurance funds are
based on insurance premiums paid by the payers established by law;
f)‘ distribution principle, which states that funds made mandatory health
insurance is redistributed to pay obligations of mandatory health ins urance system,
according to law;
g)‘ principle of autonomy, under which compulsory healthcare system is
administered independently, under law, and health care providers providing care in
this system works on principles of self-financing and profit.
For the uninsured, pre-hospital emergency health care costs for primary care and
specialized medical care and hospital outpatient care for socially conditioned
diseases with major impact on public health, are covered from the compulsory health
insurance funds means care, according to the list established by the Ministry of
Health.
The quality of the insured person is confirmed through the issuance by the insurer,
in the established policy of mandatory health insurance, under which the full amount
insured person receiving medical assistance provided in the program and granted the
unique health care providers.
The insurance policy is a document of strict accounting and issued by the insurer
based on:
a) lists the nominal record of insured persons employed by employers l isted and
updated;
b) lists the nominal record of insured persons at state expense, provided and
updated by authorized institutions;
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c) identity documents and other documents certifying the right to obtain policy by
persons obliged by law to provide indivi dually.
The ’

  
 
 
 , the relationship between the insured and the
insurer, the rights and obligations of each party is determined by the insurance
contract. The conditions of voluntary insurance are set by the insurer, in accordance
with the laws and regulations of the Supervisory àuthority.
Voluntary health insurance can be both collective and individual, but not mass,
unlike the universal compulsory. For individual insurance, the insurer concluded
insurance contract with each customer individually. n the case of collective
insurance (group), the insurer conclude the contract not with a particular person, but
with staff representatives of workers (government and trade union committee).
Voluntary health insurance is complementary to the mandatory. Following insurance
protection under the voluntary medical insurance contracts is not basic social
protection, but add the element of social protection guaranteed by the mandatory
health insurance. This type of insurance plays an important role in the context of lack
of funding from the budget.
There are two approaches. Let us compare the insurance products that underlie
them.
First approach. nsurance is based solely on risk-related expenses for medical aid.
n this case the insurance products of voluntary health insurance has medico -
technological nature. n it is described that care received by the insured in case of
occurrence of insurance case. These actually are the same paid medical services
received by the contribution (payment) of the insurer. This approach is much more
expensive just as the insurer receives for managing this product. Unfortunately, we
can not omit this fact, because he gives the best idea (views) of the Law on
compulsory health insurance.
The second approach. Optional health insurance is based on the principles of
health insurance. The purpose is to ensure all interest related medical issues,
maintaining and protecting health, but not only that part which relates to the
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provision of healthcare. nsurers take a number of risks of expenses that arise from
the use of ineffective methods of treatment, loss of body parts or its function,
decreased work capacity. àll have a f inancial expression and placed under the
grading of risks can be transferred to insurance. Liability insured under these risks
can suddenly increase the attractiveness of the insurance product to potential
customers. Of those exposed to conclude that compu lsory health insurance and
voluntary health insurance can not be merged into a single insurance company health
insurance practice by the principles and approach second accident insurance.
We choose the latter approach and all subsequent exposures will be d isplayed in
this key.
[stablishing principles and rules of insurance products
With the advent of health insurance requirements for implementation of voluntary
health insurance appears the necessity of establishing insurance programs.
Basic principles:
1.‘ àctivity in base of laws in force.
2.‘ Strict division of fields of activity for setting correct programs.
3.‘ Findings of the necessary volume of medical services rendered on a program
in correlation with the cost of medical services.
4.‘ ifferentiation by the volume of maintenance programs.
5.‘ Using statistical methods in the formation of insurance programs.
6. Forecasting.
7. àdaptation .
8. mplementation.
Problematic situation for voluntary health insurance can be determinate by the
following case: it is necessary for the insurer to form an attractive package of
services, but in such a way, given that the package will not stimulate the increase of
medical services.
Unlike the mandatory insurance, voluntary medical activity is an important form
of commercial finance and insurance is a part of persons insurance(Table 1 .1.1).
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xhe main distinctions between mandatory health insurance and
voluntary health insurance
N Mandatory health Voluntary health insurance
r. insurance
1. à compartment in the Form of insurance with financial-
social security system. commercial activity, which refers to
personal insurance.
2. t covers only the law on t is regulated by the Law on
mandatory health insurance.
3. Terms of assurance shall be
determined by the CNàM.
nsurance and other government
ordinance refers to entrepreneurial
activity.
Terms of assurance shall be
determined by insurance companies.
4. s binding. t has a voluntary character.
5. Universal s done individually, in groups or
families.
6. s performed, usually by s carried out by insurance companies
insurance companies with with different forms of ownership.
non-profit.
7. nsurers are employers and nsurers are individuals and
employees, state, local businesses.
administrative bodies.
8. Prices are set by law, in Prices are set by contract, based on
coordination with the actuarial mathematics.
compulsory subjects.
9. Revenues may only be used Revenues can be used in any
for developing the core commercial activity commercial.
business - insurance required.
1 The unique program is àssurance program is established
0. approved by the state. under the contract between the insurer
and the insured.
1 Prices for services provided Prices for services provided by
1. by medical institutions are medical institutions are established by
established by agreement bilateral agreement.
between the subjects.
1 The volume of medical The volume of medical services is
2. services is limited by limited by the amount of insurance.
financial ability of medical
institutions.
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1.2. Social bases of health insurance

Health insurance is part of a broader context, known as social policy, having as
main object of study social services and which, together with human health, as well
as areas of reference include: social security, housing, education, unemployment and
imprisonment. They are not limited to a simple analysis of society and its problems
(poverty, inequality, discrimination, marginalization, unemployment), but have in
mind and mechanisms to address the problems in question, resulting in decisions and
actions welfare to be achieved. Everything is analyzed in the context of social
policies and the institutional architecture that implements programs and providing
welfare support. For this reason, in addition to actions directed towards achieving
public welfare, are envisaged and arrangements based on specific actions that each
area can be achieved at as high a level of efficiency and effectiveness. Taking the
political science concept of cyclical political process, generate and review of social
policy can be described as an interactive model, as it is presented in Figure 1. 2.1.

  


dentify social
problems
Evaluation of
Political
policies and
proposals
effects

mplementing

àll these features are associated with the concept of welfare, which is - in fact - the
main objective of social policy. The measures undertaken, both economically and
from a social perspective, aim to improve quality of life by providing community
members a decent living, a concept known as collective welfare. ndividual and
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collective welfare can be achieved both by direct mechanisms arising from the
functioning, in which case we are dealing with a primary distribution, related to
mechanisms of resource allocation and income and the redistributive nature of the
transfer mechanisms.
n the process of operationalization of social policies can make a record of their
focus to an object generically called social security, representing all actions taken by
the society for the prevention, reduction and elimination of consequences of events
considered *social risks* that have a bearing on the level living and the quality of life.
isease, ignorance, poverty are considered to be fundamental risks human which
may generate each other or may become centers generating new ones.
Social protection system is a set of programs that are designed to protect
individuals from the situation interruption or loss of earning capacity.
Social security can be defined as a set of mea sures laid down by law, aiming to
maintain income individual or family concerned to provide an income if all sources
of income have disappeared or when, exceptionally, involved enough large spending
that may put population at risk.
Meanwhile, Social Security can provide financial resources people in need from
different cases (illness, disability, unemployment, loss of spouse, maternity and child
care increase, the withdrawal of active life).
One can see easily that social security programs are designed not only to protect
individuals, but also their families, in situations where loss of income or insufficient
income.
For this reason, the ultimate organization of the nternational Labor Organization
(LO) uses three criteria for defining social security:
1.‘ Linking financial support of medical treatment and / or medical care, income
maintenance measures in case of involuntary loss (in whole or in part) of ability to
work in a manner in which to include family financial problems;
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2.‘ The existence of legal provisions concerning rights and obligations of

individuals in relation to each of the components of the system (public, private,
public-private partnership);
3.‘ àppropriateness of mechanisms for security management system principles
specific to each component.
ànother concept is the basic social security, representing a special form of
protection that society attaches to its members support one way to counteract the
effects of various economic risks (loss of income due to illness, due to reduced
working capacity in old age, because of unemployment).
Health insurance differs significantly from other forms of public aid or support.
The benefits depend, in general the contributions and rights of those who are
receiving them. Contributions come from individuals emplo yed, from employers and
in some cases, from state budget. They are collected in special funds that provide
financial support to beneficiaries.
Health care services and health insurance benefits from an increased interest in
social insurance, not only becau se it covers a distinct category of risk, but also
because this sector consume appreciable amounts of resources. à marked
demographic reality of the aging population, due to technological development in the
field, makes the demand for health services to provide a strong dynamics.
t must be said, however, that health insurance is not just a way of managing these
risks, which may add other methods or techniques, among which we mention:
‘ Control, by practicing a proper diet, a program of exercise, avoiding s moking,
excess alcohol products;
‘ àvoiding risk (for example, proscribing certain dangerous sports);
‘ Voluntary private insurance system to cover medical expenses, the costs of
long-term treatment, or reduction in income during incapacity for work;
‘ Establishing personal reserve for medical expenses not covered by the public;
‘ Transfer risk (for example, by clause of the contract of employment that
employers provide accountability for certain medical costs of employees).
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1.3.Principles of classification of health insurance.

Medical insurance are classified by the same principles as other types of insurance.
às mentioned in previous chapters, it is necessary to classify the concepts of medical
insurance, health, medical expenses for illness. These concepts are not s ynonymous
and its information content is very different, also the principles of classification are
only principles and are not defining in classification. Each principle is part and other
principles of classification. t allows to easily understand the co ntents of each medical
insurance. So health insurance can be classified as follows:
à
 

1.‘ mandatory health insurance;
2.‘ voluntary medical insurance.
à
  



1.‘ medical insurance for the entire population;
2.‘ medical insurance for a certain area;
3.‘ international medical insurance.
à
 
© 
   

1.‘ individual health insurance;
2.‘ family medical insurance;
3.‘ collective medical insurance;
4.‘ medical insurance for the entire population.
à
 ’
© ’   
1.‘ ëomplex:
½‘ advanced medical insurance;
½‘ complex health insurance;
½‘ complex medical expenses insurance;
½‘ complex insurances for diseases.
2.‘ Insurance on certain groups or diseases:
½‘ medical insurance for certain groups of states or diseases;
½‘ health insurance for certain groups of conditions or diseases ;
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½‘ health insurance costs on certain groups of states or diseases.

à
 ©

 ©
 
   
 
½‘ full payment ;
½‘ pay a share of the amount of insurance or expenses;
½‘ payment by applying various reliefs;
½‘ with overlapping claims,
½‘ cash;
½‘ by transfer;
½‘ insured;
½‘ service provider.
à
 ©

 ©
 ’ ’  
½‘ actual expenses payment;
½‘ paying the cost of day / bed;
½‘ according to the norms for treating a case of insurance;
½‘ by paying the annual budget, based on the number of insured persons attached
to the service.
à
  
 
 
½‘ insurance for short period - one year or less;
½‘ insurance average - 1-5 years;
½‘ insurance for long - 65;
½‘ health insurance for whole life.
Health insurance is a form of insurance designed to cover all or partial
hospitalization costs if hospitalized exceeds a certain number of consecutive days
(usually 3 or 5), the cost of medical treatment as a result of illness or injuries in
insured or compensation coverage for illness or income during illness.
The risk of death is not insured.
nsurance premiums are different for men and women. às in other types of health
insurance contracts, it establishes a waiting period, only after which the coverage
becomes effective, it can be 3 -6 months.
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Costs covered include:

½‘ hospital;
½‘ of convalescence;
½‘ treatment at home after discharge;
½‘ maternity allowances;
½‘ advice from a family doctor;
½‘ consultation, diagnosis and / or fees to specialists (radiology, ultrasound,
oncology);
½‘ surgery;
½‘ private ambulance services;
½‘ repatriation costs;
½‘ rental of a wheelchair, and others.
Level premium insurance is calculated according to the occupational categories,
due to various risks.
Insured amounts paid may take the following forms:
1.‘ Lump, representing a daily allowance of a fixed amount for hospitalization or
surgery;
2.‘ Reimbursement of expenses of hospitalization in the form of allowances for
private hospital services, medical / surgical .
n the papers devoted to insurance risk assessment is a new concept - the
cumulative risk.
The concept of cumulative risk is understood all the risks that accumulates the
likelihood of a case and the same insurance. This action occurs in case of the force
majeure (natural disasters). Methods of prevention, compared with other medical
services related to treatment of diseases, are much cheaper and easily subject to
calculation. à major application of preventive methods have collective contracts,
especially in adverse conditions where persist the teams work.
t is possible to finance preventive services at the expense of the employer and
insurer (Figure. 1.3.2.).
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  ‘x


 
  

   
‘

Material interest regarding

Insurance object health maintenance and
recovery
‘
‘

Risks of the first

order

Risk of loss of Deepening the risk

Risk of loss of The risk of chronic
health as a result of of chronic and
health from illness diseases
trauma, poisoning acute diseases
‘

Risks of second order

Expenses for medical Damage from medical The damage from the
services technology ineffective treatment
‘

Insurance Cases

Medical services Loss of

Loss of a body part Death
under contract employment

‘



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ëhapter II. Studying the health insurance market in the Republic of Moldova
and in countries with highly developed economy.
2.1. Existing medical insurance forms in countries with developed economy.
Every system of health insurance is different, so that basic health services package
definition is directly and indirectly influenced by the particular systems of each
country, even if they do not work in isolation. n the following we intend to
emphasize the structure and content of the basic package of several developed and
developing countries, selected from different geographical regions in order to
highlight the main factors of influence to be taken into account in this respect.
1.‘ European Experience
n Ireland, the insurers were not impose restrictions regarding the c overage of
health care providers. There are, however, the requirement to establish a minimum
level of benefits to cover all health services and offers insurance plans should cover
care in public hospitals. Virtually all health plans cover both services in public
hospitals and in private, which represents the largest part of private health insurance
market. Plans with the lowest coverage level support accommodation, meals and
semi-private care in public hospitals, or an equivalent level of coverage in privat e
hospitals, while more comprehensive plans bear the full cost of treatment in any
private hospital.
àlthough it represents only a fraction of the total cost, and all plans must provide
coverage complementary to the contributions paid by those who seek th e services of
public hospitals, the hospital costs for personal expenses is limited.
n contrast, coverage for primary care is less comprehensive, so that over two
thirds of the population supports the individual costs for this type of medical services.
Over time, private health insurance market has not proposed to cover these costs but
to provide protection for medical costs in case of disaster.
We are not dealing with a list of priorities in terms of medical services but with an
implicit approach to the basic package, used for both hospitalized patients and for
those who are not hospitalized.
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n the Netherlands, the basic package of health services is defined mainly by the
Central Government, by establishing broad categories of services. Basically, it
established a list of categories of service that every patient has the right (the nature of
the medical, pharmaceutical,) specifying the areas of care covered by the insurance
scheme, without specifying in detail what are the rights of the insured.
Nomination excluded from the basic package of services is a government decision
to regulate medical care. This excludes a number of transplants and plastic surgery
procedures, stipulating which of the categories of transplant are covered and that
access to a range of other medical services is allowed only under certain conditions.
Through such regulations of some services are excluded as well as reconstructing
eyelids, body sculpting, fertilization *in vitro*, sterilization, and circumcision. Policy
on fertilization *in vitro* has changed several times, insurers now cover only those
medical procedures after a first attempt at fertilization (paid directly by the insured)
has failed.
Pharmaceutical prescriptions during hospitalization is a part of the right to medica l
care, they are funded, in general, by the hospital budget. nsurers may cover, in
addition, a very expensive part of the cost of drugs prescribed during hospitalization.
àn exception to the usual rules of health services is a specialized psychiatric care
in the area, whose coverage is provided by a special law. Outpatient psychotherapy is
covered financially within certain limits and only if there is a reference to the general
practitioner or psychiatrist. Rights of patients with such disorders include tr eatment,
supervision, accommodation and food, special regulations are applied for child care
and for treatment with substances that generate addiction. The introduction of mental
health care in the basic package is an objective of future legislation on the matter.
n the Netherlands, pharmaceutical costs are relatively low compared with other
European countries, medicines represent less than 9% of total health budget. n recent
years, however, the cost of spending on medicines significantly increased, whic h can
be explained partly by the increase of elderly population, the increasing incidence of
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chronic diseases and medical prescriptions, an additional factor in this regard is the
emergence of new drugs, more expensive than those used previously or replace them.
n an effort to preserve public access to pharmaceutical products, government took
a series of measures to control drug costs for patients not hospitalized, the Health
Ministry is responsible for deciding whether a new drug will enter or not in the
package and also it decides which to remove from the package of medicines made
from a therapeutic standpoint.
Government is the settlement system which adopts the basic package of drugs and
he also sets maximum prices, by a law dedicated to this purpose. n addition,
government actions aimed at boosting the role of the market on a competitive basis in
order to maintain prices at a level as low as possible.
àpproved drugs do not automatically qualify for settlement in the basic package,
some of which are only partially compensated, while others go through an evaluation
procedure and analysis before taking a decision in this regard. etermining factors in
the evaluation process are the therapeutic effect of the products concerned and that
they do not exceed the cost of similar drugs from the basic package.
The settlement system determines the compensation for medicines, based on the
average cost of drugs with similar effect that can be replaced and which are
considered as a group of substitute products. f the price of a particular drug is higher
than the group average, the additional cost will be borne by the consumer. Basically,
there are enough alternatives available to allow selection of a drug completely
compensated, so that patients can buy medicines wit hout having to pay extra.
Ministry of Health intends to lower the cost of medicines are not patented, as well as
compensation for drugs for which there is a proprietary alternative.
Programs to support pharmaceutical research is subsidized by the governmen t.
They were initiated by the pharmaceutical industry, in collaboration with the
Government of universities and research centers. The purpose of these programs is to
sustain and increase the number of interdisciplinary studies pharmaco -economic
field.
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istributed drugs outside hospitals are covered by a special law. They are
published in a restricted list of medicines qualified for compensation. Medications
distributed in hospitals, are part of health care rights and settlement system are
covered by the insurance system.
From the above results that there is a difference between medicines to patients in
hospitals and those of patients who are hospitalized. Settlement of the prescriptions
made by community pharmacists is regulated at the central level, wh ile the drugs
prescribed in hospitals follow a liberal policy. Such an approach has led to some
variation in terms of availability of certain categories of drugs (usually more
expensive) in hospitals and in directing costly patients to specialized treatme nt
centers. The new hospital financing system would change that decision makers in the
field and will require hospitals to regulate the supply of more expensive drugs.
n the Netherlands, primary care services, dental care and curative benefits covered
by insurance system covers the following aspects:
a.‘ Primary care provided by general practitioners is regulated by legislation on
health insurance. This involves home visits, consultation, pharmaceutical
prescriptions, referrals to specialized physicians and other less important activities.
The rights to these services are explicitly defined, each type of care is covered by a
specific treatment plan, according to professional standards.
b.‘ Rights relating to the nature of dental health care have been specified
explicitly, long ago. The regulations in this regard stating that they are entitled to
such care to all persons aged 18 years. ental treatment includes 14 types of services,
including regular consultants, fluoride treatment, fillings. àdults are entitled to
medical care only in certain circumstances set forth in documents on conditions for
granting special dental services for people with mental or physical disabilities.
c.‘ àn important method of influencing the amounts allocated to medical services
is the practice guidelines. There are many such disciplinary and interdisciplinary
guides, both for primary and for the secondary care, some of them based on economic
coordinates. Between 1998 and 2002, the utch government programs were
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structured in terms of practice development, which led to the appearance of 31

therapeutic guides, which refers to the 23 disorders in some groups of diseases. These
guides therapeutic, self-regulated, are used by doctors as a rule of practice in the
field, both within and outside their hospitals. They serve as a landmark in defining
the best standards of care, according to clinical diagnosis. Paramedical care such as
physiotherapy, speech therapy services, curative and ergo -therapy treatment are
covered partially.
-ermany has the richest practice of health insurance and decentralized system of
compulsory health insurance. Germany currently consumes approximately 8.1% of
gross domestic product. àlmost 90% of the population engages in mandatory health
insurance and 10% receiving medical ser vices through voluntary health insurance
judgments. 3% of the population full fill compulsory health insurance policies
through voluntary health policy to higher quality health services, in a more
comfortable and in full volum to the doctor or health care institution preferred.
The financing of medical institutions in Germany are divided as follows: 60% by
health insurance funds, 10% through voluntary health insurance, 15% through state
allocations and 15% of citizens through their own sources.
Health insurance funds are accumulated from three sources: state budget, the first
employer and employee premiums. àverage premium is 13% paid equally by
employer and employee.
n Germany there is no law on compulsory health insurance. Health insurance is
divided into three main categories: social, by law and voluntary:
1)‘ Social nsurance
t is a supplement to Social Security that allows to obtain health services in
ambulatory and stationary conditions and the dentist. On these policies most patients
receive also free medication. For this policy the insured person does not pay
anything. àll costs are incurred by local government policy where the insured person
lives. Policies (one for GP and one for the dentist) are remitted to the insured person
in each quarter. Policy is withdrawn by the doctor when addressing, such the person
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which have social policy of carrying health insurance can not appeal to another
doctor than the designated by policy, but if necessary, the GP sends a patient to any
specialist who patient needs. There in a free choice of doctor in Germany. So even
people who have no income and access to qualified medical assistance. Persons who
are under the protection of social assistance (homeless people - people without
residence visa and other categories) do not benefit from these policies.
2)‘ Ensure by law
This type of insurance covers 80% of the population of Germany. t is mandatory
for all employees with lower income levels than established (currently this income is
about 6000 ¼ / month). nsurance is carried by hospital houses. These houses are
organized on the principle of ter ritorial or special guild houses seamen, miners,
federal homes, homes of farmers. However, the person is free to choose their own
insurance fund. nsurance premiums are paid by the insured person a percentage of
her/his salary in half and is paid by the employee and the employer. Each house has
insurance that different percentage value, from 9 to 14% from salary. Evidence of
accumulated resources and other necessary information are entered on magnetic
cards. The insured person may receive medical services a t any medical facility in
Germany. f the insured person has a higher income than he established he covers a
part of the cost of medicines, and if revenues are lower than the level set the person is
exempt from payment of a part of premium. Students are re quired to ensure
admission to the institution. The monthly premium for a student is about 80 ¼.
Compensation paid by health insurance can be divided as follows:
1.‘ compensation for maintaining health - health enlightenment and methods of
disease prevention;
2.‘ compensation related to prevention of dental diseases (including schools and
kindergartens), specialists in preventive measures, including supply of medicines,
dressing materials, curative and auxiliary supplies as well as preventive measures for
women;
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3.‘ compensation for early diagnosis of diseases. nsurance policies provide that
policyholders aged over 35 years every two years have to pass a rigorous medical
examination, annual inspections of cancer prevention for women aged over 20 years
and men aged over 45 years;
4.‘ compensation for treatments that are divided into:
½‘ dental care, including prosthetics;
½‘ free supply of the standard package of medicines and dressing materials
Note: additional costs related to procurement of drugs and dressing materials are
more expensive and higher quality are incurred by the insured;
½‘ auxiliary material supply, with payment of 10% for insured adults;
½‘ free supply of hearing, and hearing aids, orthopedic and if these devices have a
fixed price;
½‘ patient care by a qualified home if hospitalization is indicated, but it can not be
done. àlso are given care and housekeeping help if the policyholder can not meet
household obligations and the in family are children up to 8 years old or disabled
persons dependent on help of the third per son;
½‘ medical expenses and other additional expenses related to medical
rehabilitation.
5.‘ compensation for incapacity. This compensation constitutes 80% of the total
amount of income after paying all taxes, starting in the seventh week of incapacity for
work because of illness.
3)‘ Optional nsurance
Voluntary health insurance in Germany is a luxury service. Under existing
requirements can be insured people who have an income less than ¼ 6,000. Until the
contract the person is subject of a medical examination as t he insurance premium
depends on health status, age and other causes. Free ssue of medicines through
voluntary health insurance is not provided. n case of hospitalization of the insured,
provided a room for him individually and curing by the head of the c linic. Holder of
voluntary health insurance policy benefits from increased attention from health
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workers. The only downside of voluntary health insurance is that (and this is
legislated), if the person was denied social security office or by law for ensuri ng the
voluntary return to traditional social insurance is not allowed.
n rance, compulsory health insurance is carried out centrally by law, regardless
of ownership. Mandatory health insurance is made centrally, by law, regardless of
ownership. Large and small collectives and free professional people, conclude
mandatory health insurance contracts. Over 80% of the population engages in social
health insurance. One of the features of the French system is franchising of insurance
payments. Mandatory health insurance pays only 75% of the cost of medical
expenses, the remaining 25% pays the person independently or by contracting
voluntary health insurance. Compulsory health insurance in France covers the
majority (70-90%) the cost of drugs purchased.
àn important feature of state activity in the social insurance is the management of
prices for medical services and cost of drugs domestically. Prices are reviewed twice
a year periodicity, and, mainly, to raise them.
French insurance companies offer to the popul ation a much wider spectrum of
medical services than those included in the package of medical services required and
mandatory health insurance system of France compensates in some cases and certain
expenses incurred by the insured.
às in other countries, health insurance funds in France consist of financial
accumulation of individuals, employers and transfers from state budget allocations.
n -reat Britain the negotiations between state and society on the organization of
health care continues over 50 years . n 1948 in England was nationalized health care,
and this time, negotiations between state, society and the patient does not cease.
Collaboration continues to build a model tends to the optimal functioning of the
public health care system and a fruitful collaboration between the three participants in
this system.
Special interest in British health care system is the work of two organizations
defending the rights of the patient:
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a)‘ a state organization, through its legal representative as Parliament in health

problems (Health Service Ombudsman);
b)‘ nongovernmental organization. Movement in defending victims of medical
mistakes - àVMà (àction for Victims of Medical àccidents).
Supplemental health problems delegate of Parliament was held in 1973. This
service is a service department of the delegate of the Parliamentary Human Rights
(Parliamentary Ombudsman). This service specializes in handling complaints about
the shortcomings in the work of national health care (and government departments
the medical staff and outpatient, dentists, ophthalmologists, family physicians).
àuthorized person is not subject to parliamentary government and is independent of
the national health system. à staff from 80 people is filled with experts specifically
trained, with medical and legal studies.
This service is represented by expert groups in three regions of Great Britain:
England, Scotland and Wels. t should be noted that the legal settlement of the case
and medical expertise are free. Preliminary, is compulsory the defendant to file a
complaint to the county health and wait for an answer, it is also necessary that the
moment of appearance of deficiency in treatment does not exceed one year. The
purpose of this service is independent assessment of the state health service and
helping patients. Conclusions of the parliamentary delegate are presented for
hearings and decision making, for the need to improve public health system.
Movement in defending victims of medical errors was born in 1982 as a charitable
movement in support of patients who suffered from various incorrect treatments. The
purpose of this movement is to protect, as far as possible, patients of medical errors,
or where it is impossible to minimize them. n case if could not avoid medical error,
patient or family should receive compensation concerned.
Movement in defending victims of medical errors on the position of the company
cautions health care system that believes that the adverse effects of treatment are an
inevitable result of insufficient funding and medical s taff overload. às a result - and
recognize the consequences of errors. The work of this movement in England has
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imposed famous English legal system to recognize that medical errors are a particular
area of activity that requires some reforms in the judicia ry of the country as well as
special training for judges to adopt the correct and timely decisions.
2.‘ American Experience
The ·nited States health care is one of the most complicated, costly (health
spending is about 14% of gross domestic product) and one of the most burdensome as
a system for management. The U.S. government covers more than 40% of all
spending for medical services rendered to insured persons.
The state covers two basic programs: *Medikeid* and *Medicare*.
State insurance program *Medicare* is a program that ensures people over age 65
or who are approaching that age, but has serious health problems. Some of the
necessary financial resources for formation of fund of this program shall consist of a
special tax that pays the employees, another pa rt is paid by the employer, in sum, that
tax revenue is about 15% of employed àmericans. The last necessary part of fund
that remains is covered by the state.
Program *Medikeid* provides insurance to the poor, mostly women and children
from socially vulnerable families. This program pays admission to nursing homes for
elderly people requiring constant care and can not do without the help of others; for
these services are spend more than half of the funds this program.
Funding for the program is twofold: the federal funds, about 50%, another part is
paid by other governments in each State.
n the United States is highly developed tradition of insurance of employee on
company account. n addition to health insurance employees can benefit for life
insurance from loss of working capacity and other types of insurance. Traditionally,
employers insure employees, but the costs for medical services provided are franchise
- the insured person pays 20% of these costs and 80% of the insurance company pays.
These types of insurance are a little like social health insurance practiced by other
countries and represents commercial insurance, but on the account of the owner. n
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the U.S. they are called ³insurance compensations´ because the insurance company
compensates the 80% of expenses incurred for treatment.
ànother commonly practiced form of insurance in the U.S. is so-called ³directed
expenditure´. The essence of these schemes is that health workers and most of them -
hospitals, nursing homes for the elderly, networks or associations of health workers
with free practice, enter into contracts to provide medical services to insured persons
in return for fixed premiums for each person. n this variant the risk that spending
will exceed revenue is removed on the shoulde rs of health care providers, evident and
their economies remain the same.
2.2. xhe place of health insurance and problems related to it in the national
sector of Republic of Moldova
The transition of the republic built on the company planned economy to a marke t
economy has had repercussions in all spheres of social life, conditioning the
substantial changes in socio-demographic situation of the country. ànalysis of the
demographic processes across the country during the transition shows a pronounced
reduction in population. The process of decreasing the population of Moldova has
held in several cases, the main being the dramatic fall in birth rates in recent years,
increased mortality and migration tide.
Medical insurance occupies a special place in the public welfare system. On the
one hand, it is closely related to other types of social insurance: unemployment
insurance cases revenue, loss of working capacity, the injury, as from disease,
accident at work, unemployment and disability, there is a close mutual c onnection.
On the other hand, it differs from other types of social insurance by the degree of
population coverage. f the unemployment insurance need people who came from the
work activity, so medical insurance need employees and citizens alike are not
enrolled in labor.
Unlike other types of social insurance, social assistance is granted medical
insurance rather than cash, but natural, because the disease can be treated based on
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the use of certain drugs and medical services. n health insurance (and the stage of
rehabilitation) should be paid and provided the interested medical goods and services.
n health insurance, medical assistance is determined by size of target -set of
patients need (medical care, treatment, etc.), which provides absolutely required, for
ethical reasons and, unlike other types of social security does not depend on the
previous wage.
n transition economies, given the sudden descent level of social protection should
focus on mandatory social health insurance on reasonable scale.
n the first half of the 90's, Moldova has worsened indices that reflect population
health: reduced life expectancy, increased mortality (including newborn), the
morbidity of infectious diseases (tuberculosis, diphtheria, dysentery bacterial,
syphilis, etc.). n transition economies, health is one of the factors that influence the
degree of adaptation to the current economic situation. For many poor health prevents
them find their place in the market economy.
Birth indices both fell in Moldova due to shrinkage in the number of women of
appropriate age, both because women refuse to give birth. The primary reason is lack
of confidence in tomorrow, the second material problems arise, the third position -
living conditions.
The decrease of birth in Moldova occurs on the back ground of population increase
in mortality (Table 2.2.2).
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Table 2.2.2

Birth and death dynamics of Moldova's population

Years Birth Death

1000 Wight in % 1000 Wight in %
inhabitants from 1950 inhabitants from 1950
(Å) (Å)
1950 38,09 100 11,2 100
1960 29,3 75,5 6,4 57,1
1970 19,4 49,8 7,4 66,0
1980 20,0 51,4 8,1 72,3
1990 16,7 42,9 7,4 66,0
2000 10,8 27,8 9,3 83,0
2005 11,9 30,6 11,9 106,2

às can be seen in the postwar period (1950 - 2005), the birth rate in Moldova fell
from 38,9 to 11,9 Å . The decrease of births during that period was 3,2 times.
àccordingly, in 2005 the birth rate was only 30,6% from the rate of 1950. àlso, we
see a great variety in character development of population mortality. n the first
decades (1950-1970) mortality rate is characterized by a decrease rather highlighted.
Thus, in 1960 formed the rate of 57% from 1950 and in 1970 - already 66%. So it is
well noted that after 1960 the rate of mortality of the population of Moldova began
to increase.
àn important role in reducing birth rates and increased mortality, once in question
shown above, takes the phenomenon of aging population (Table 2.2.3).
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Table 2.2.3
ëhanges in the age structure of the Moldovan population (%)
Age 1979 1998 2005 2005 weight in
% to 1979
0-9 25,9 18,3 16,9 65,3
10-19 16,1 18,3 18,0 111,8
20-29 17,3 18,0 13,9 80,3
30-39 14,8 11,5 15,7 106,1
40-49 10,4 12,6 13,4 128,8
50-59 7,9 10,5 9,0 113,9
60-69 4,9 6,4 7,8 166,0
70 and over 2,9 4,4 5,3 182,8

às shown (Table 2.2.3), the age structure of population is a perceived reduction in

the rate of younger age groups as a result of reduced birth rate. àt the same time
increase the rate of old age groups. So, for example, the share of population aged 0 -9
years in 2005 constituted only 65% of the corresponding rate in 1979. àlso the share
of age groups over 60 increased by 166 and 182.8%, respectively.
The demographic factor in the next 10 years will have a destabilizing influence on
the economy (social and military spheres).
ncome difference also plays an important role in stimulating people's initiative to
conclude a contract of health insurance and oriented towards increasing the efficiency
of labor, which in turn is exacerbating inequality. nequality, t herefore, is a close
connection with economic efficiency, and the company is putting the task: how
should redistribute income, to minimize loss of effectiveness.
irector E. and J. Stigler (USà) have concluded that compels state income
redistribution in favor of the interests of the wealthy and middle class but the poor
have almost nothing.
Redistribution to social protection is performed by several methods:
½‘ transfer payments, it means benefits paid to low-insured groups, pensioners,
unemployed etc.;
½‘ price regulation at important social production;
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½‘ indexation of fixed income and transfer payments in relation to the inflation

rate;
½‘ statutory minimum wages in all spheres of the economy;
½‘ imposing progressive taxes for which tariff revenue increases as the nominal
size. This determines the actual size of the income tax roll and rate, influencing the
size of savings, determine the size of the real demand.
The system of social protection in transition economies must ensure the health and
lives of all population groups in case of the general risks of life (old age, sickness,
unemployment, accidents, etc.), to standardize the initial distribution income market
conditions (special allowances unemployed, housing subsidies, payment of
compensations to families with many children, pensions and student grants) and
prevent worsening working conditions in production (the injury prevention field
production, protection of youth work, etc.) and the general situation labor markets
(middle looking for work, professional counseling, paying benefits to persons who
work only a half day).
nsurance is an effective means of social protection of population in conditions of
market economy, it carried the principle of a single space (general) social issues
unique standards when the state (general) population social protection, minimum
guarantees in payroll administration, paying pensions and granting benefits,
scholarships, medical assistance in the areas of education, environmental protection
of the population - by creating the appr opriate legal basis to national and local
territorial level, in line with economic conditions change: the standard of living, price
index and labor income growth.
Providing social assistance to ensure a record number of people with the poor
class, the principle of social self-protection system, where the administration of social
insurance bodies are freed from direct state administration system.
Health insurance market is largely affected by the causes of deaths occurring after
illness.
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n CS countries, first in cases of death are cardio-vascular diseases, the second -

oncological diseases, on the third - the reason is external (accidents, suicides,
murders, accidental poisoning, including alcohol). The last group of diseases is an
important factor in the loss of potential years of life, because they affect youth and
people of average age.
The same situation is in Moldova (Table 2.2.4).
 

Mortality causes of Moldova's population (in%)
1995 2005
xotal deaths 100 100
Reasons: nfectious iseases 1,2 1,6
Cardio-vascular diseases 43,2 50,3
Malignant Tumors 13,6 11,6
Respiratory iseases 6,6 6,2
igestive iseases 9,5 9,1
Nervous System iseases 0,7 1,0
àccidents and poisoning 10,6 9,5
Other diseases 14,6 10,7

às we draw conclusions, the place it occupies predominant causes of death

between cardio-vascular diseases for which the rate of growth is a visible trend.
Worsening socio-economic conditions of life of people, reckless attitude towards
healthy lifestyle (improper food, smoking, alcohol), lower health -epidemiological
control, ecological crisis because of factors which increa se social stress and the
morbidity and mortality.
The economic crisis has negatively influenced health care in Moldova, to maintain
previous volume level for the granting of basic health services.
The transition to market relations, the liberalization of p rices and tariffs for goods
and services, the cause of the increased cost of treatment and preventive care, has
worsened the problem of funding. Regardless of the large number of doctors and
hospital beds per capita, medicine is no longer able to protect h uman health. t's not a
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secret for anyone that is currently in Moldova patients are forced to come into
budgetary hospitals with medicines, linen, own food.
Medical insurance system in the transition economy is a system of reports on the
protection of material interests of the population, health related. This protection is
made contributions towards the expense of training to ensure health insurance funds,
to pay for healthcare insurance if needed.
àny type of insurance, primarily health insurance to be cha rged correctly, should
be well thought out on a technology plan.
The unique program of compulsory insurance provides that upon occurrence of
health problems, the insured person or emergency service is addressed to the family
doctor. n the case of voluntary health insurance, the person may apply to private or
emergency medical service specialist medical institution, upon request, for
consultations, investigations and treatments. Placing scheduled (for chronic diseases)
in public medical institutions shall be made only upon:
½‘ ticket issued by the family residence under visa of the patient (principle of
territoriality);
½‘ regional advisory councils medical decision;
½‘ Regulation stating internment scheduled medical institutions (waiting lists).
The causes of bad health in Moldova are the prevalence of risk factors in lifestyle
and environment, and the absence of effective prophylaxis and the low level of
medical services. The situation is not corrected by the already developed programs
because of insufficient fundin g.
Health is not only one basic human rights, but also a state resource, a necessary
condition for progress of society, to be achieved through: improving people's living
standards; promoting a healthy lifestyle, environmental protection and enhancing
efficiency of healing and prevention of diseases, improving health services through
more sustained application of economic levers and diversification of financing of
medical institutions; strengthening the institutional capacity of public health sector by
issuing the legal and health management restructuring.
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ëonclusions
Making a full study on the insurance market problems and the mechanisms of legal
regulation of health insurance in Moldova have arrived at these conclusions, and also
formulating some proposals:
1.‘ For a more extensive protection of population against unwanted consequences
of insurance events, the state creates conditions for ensuring the protection in
individual insurance - health insurance. The establishment and development of health
insurance is a necessary condition of national economy's recovery.
2.‘ Research situation on the insurance market in Moldova currently generates
Track the conclusion that market is still in formation stage. Research on the market
situation this is due to: 1) low purchasing capacity of the main consumers of
insurance, 2) inadequate capitalization of the insurance, 3) unfavorable taxation
system, 4) lack of economic incentives, 5) lack of knowledge and experience in
implementing on the market types of mass insurance.
3.‘ à current issue of the domestic insurance market is the small number of
proposals from insurers. Moldovan insurers currently offering 30-40 budge types of
insurance services, while insurance market research in developed countries shows
that the services of over 300 insurance the most varied types.
4.‘ Considering that in most European countries the insurance supervisory bodies
are separated by institutional and absolutely independent, we believe that for
effective supervision of insurance activities, nsurance Sup ervision nspectorate and
non-state pension funds must be separate from the Ministry of Finance and
subordinate to Government directly. Control bodies must be independent, free from
departmental interests, have clear responsibilities, based on the law.
5.‘ We believe that financing of the insurance supervisor should be done at the
expense deductions of insurance premiums collected by insurers on all types of
insurance or certain types, based on the estimate approved by the Government.
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6.‘ n order to guarantee the payment ability and financial stability of insurers, we
believe necessary to operate on the insurance law of RM a number of restrictions on
insurers by the end of legal documents.
References:
1.‘ Law on mandatory health insurance Nr.1585-X from 27.02.98
2.‘ Law on nsurance nr. 407-XV from 21.12.2006.
3.‘ Capsizu Valeriu,Lascu umitru, Covali Olga Finanţarea ingrijirilor de
sănătate in ţările cu economia in tranziţie // Studia Universitatis. Seria ÄŞtiinţe
Exacte şi Economice´. í Chişinău: CEP USM, 2008, Nr. 8 (18)- P. 142 - 147.
4.‘ C. Eţco, u. Malanciuc, V. dricean. mportanţa marketingului in perioada de
trecere asistemului ocrotirii sănătăţii la economia de piaţă // Revista ÄSănătate
publică, economie şi management in medicină´. Chiţinău, 2004, nr. 4, p. 21 -23.
5.‘ C. Eţco, u. Malanciuc, V. dricean. ÿrincipiile conceptuale ale asigurărilor de
sănătate// ànalele ştiinţifice Volumul , Problemele medico -biologice, farmaceutice,
de sănătate public şi management. Zilele Universităţii 16 -17 octombrie 2003, p. 398-
403.
6.‘ V. dricean. ëalitatea serviciilor medicale şi aprecierea ei in cadrul
asigurărilor de sănătate // ànalele ştiinţifice Volumul , Problemele actuale de
sănătate publică şi management.Zilele Universităţii consacrate jubileului 60 de ani ai
invăţămintului medical superior din Republica Moldova. Ediţia V 3 -7 octombrie.
Chişinău, 2005, p. 260-263.
7.‘ V. dricean. ëalitatea serviciilor medicale şi aprecierea ei in cadrul
asigurărilor de sănătate // ànalele ştiinţifice Volumul , Problemele actuale de
sănătate publică şi management.Zilele Universităţii consacrate jubileului 60 de ani ai
invăţămintului medical superior din Republica Moldova. Ediţia V 3 -7 octombrie.
Chişinău, 2005, p. 260-263.