There are two options for the person requiring care: the public healthcare system, financed by the government, where one is supposed to be cared for without cost if they hold medical insurance, and the private healthcare system, which is not really a system but is made up of different, unrelated private clinics or hospitals, where one must pay all expenses out of pocket. Let’s look at each system in more detail.

Public healthcare

I believe there are three main problems plaguing public healthcare in Romania:

1. Widespread corruption at all levels of care. Bribes must be paid to hospital directors, managers, doctors and nurses, and sometimes even to hospital guards, if you are to get any competent care other than a daily temperature and blood pressure check until you check out or expire, whichever comes first.
2. Incompetent personnel, due to:
   1. An inefficient medical education system, staffed with teachers and professors who care more about furthering their own careers, brown-nosing and getting bribes than teaching students how to be proper nurses and doctors.
   2. An unwillingness on the part of most students and medical personnel to put in the effort to acquire the knowledge they need to do their jobs right.
3. Old facilities and equipment. Hospitals and clinics lack the funds to maintain the infrastructure properly, so all of them are run-down, cold in winter, hot in the summers, with drafty rooms and hallways where you’re likely to catch pneumonia, with bathrooms that have leaky faucets and leaky toilets, mostly left uncleaned, smelly, wet and old, with metal beds that date way back from the 1st or 2nd world war (I’m not kidding about this), and with mattresses that have seen more than their fair share of human bodies and bodily fluids. When it comes to equipment, it’s mostly non-existent, other than basic X-ray machines.

Sure, there are exceptions. There are some doctors and nurses who don’t ask for bribes. And there are some medical personnel who are competent at their jobs — they know how to do them and take the time and effort to put their knowledge to good use. But if you think the two groups contain the same people, you are probably mistaken. It’s usually the doctors who are the most competent that demand the bigger bribes, though it could be that a really good doctor or nurse may also be the one who doesn’t ask for or accept bribes. There’s no way to tell, really. It’s like taking a potshot in the dark. You’ll go to get some care and may end up with a butcher or a blundering fool who only makes things worse, and you may also end up paying him or her plenty of money for the shoddy treatment.

On some level, I understand why the corruption exists. Salaries for government-paid doctors and nurses are very low — janitors at profitable private businesses usually make more money than doctors in government hospitals — but that’s still no excuse for the endemic corruption. While salaries are low, medical personnel have also gotten used to asking for money from each and every patient, to the point where they expect it for the littlest thing and won’t help you if you don’t pay. There’s a ridiculous, infuriating sense of entitlement among most, if not all of them. Somehow they’ve gotten to think you owe them money simply for looking at you. That’s not right.

If only they’d take the time to study more, to get better at their craft, I, along with the millions of Romanians who visit hospitals, would feel better about paying extra to get care, but most are ignorant of any new developments in their fields. They only know enough to get by on routine matters. As soon as there are complications, they’ll take your money for a consultation, then tell you to go see this other doctor, who’ll ask for his share, then send you along to another, and so on and so forth until you’ve seen seven, eight, nine, ten doctors, have spent a month’s or two months’ salary on bribes, and you’re still no closer to getting treated right or cured. They’ll all nod their head, promise to help, take your money, run their tests, then scratch their heads and say they’re not sure what’s going on, that you’ll need to come see them again in a little while, etc., while happily fleecing you.

When it comes to government nurses, they won’t administer the injections or infusions or obey the doctors’ orders if you don’t slip them a bill, or some coffee, or chocolate, or whatever. It has to be something a little more expensive than just some candy or a trinket, and let me tell, when you’re being seen by four or five nurses and you need to make sure each of them gets something, it gets expensive. It’s so sad to visit hospitals and see all the old people on small pensions walk about with sad looks on their faces, mostly ignored by the nurses who are supposed to care for them, simply because they can’t afford to bribe them.

Private healthcare

There is hope when it comes to Romanian healthcare, and as is usual in a free enterprise system, it’s found in the private arena, where there are financial incentives for those willing to take some risks and make some investments in buildings, medical equipment and qualified personnel.

There are private clinics and hospitals, completely separate and unrelated to the government, where you can get competent care if you have the money to pay for it. Truth be told, it may end up costing you less than government healthcare if you add up all the extra costs involved with bribing government personnel.

Only the best doctors and nurses get hired in the private clinics and hospitals, are paid good salaries, are forbidden from taking bribes, and these facilities are equipped with the latest devices needed for proper patient care. There are entire hospitals and sanatoriums placed in beautiful locations in the mountains, where you can go to spend a few weeks to relax and get allopathic or natural, holistic treatments. There’s an entire gamut of options available to those willing to pay out of pocket.

For example, let’s say you need to run a whole battery of tests to see how your body is doing. You can go to the local government hospital, see and bribe a doctor to get some tests, then go to five or six different labs inside the hospital to run those tests, bribe your way through each place, then come back to the doctor in a few days to give him or her more money to look at the test results and tell you what’s going on. Or you can check into a private clinic, where for a fixed cost, you will spend a few days in a clean, private room with proper heating and cooling, pick your food from a menu, have your meals served to you, be able to take showers in a clean bathroom, be seen by caring, competent doctors and nurses, and get accurate test results interpreted properly. That’s the difference.

I should mention that private doctors’ offices aren’t the same thing as privately-run clinics and hospitals. Many government doctors also keep private offices, and will actually force people who come to see them in hospitals to go to their private offices and pay out of pocket to get the same care they could get for free in hospitals, but the care patients get there is just as bad as inside hospitals, and the facilities are usually just as unhygienic and inefficient. No, you must seek out professional private clinics and hospitals if you want to get the serious care I mentioned above.

Possible solutions

I think you know by now which option I would pick if I were to get sick in Romania, and for good reason. That’s not to say public healthcare can’t be fixed. In recent years, there’s been a serious push against corruption in Romania, at all levels of government, not just in healthcare, driven by the EU, but they haven’t made much headway other than talking about it and putting up posters in government agencies. Much more needs to be done, and it needs to start first with better salaries for medical personnel, probably double or triple what they are now.

Corruption in Romania is a very serious problem, one that requires an organization with teeth, one that can and does take immediate action against infractors, and where the identity of the person reporting incidents of corruption is kept top secret. Sadly, the system is still stacked against those willing to report it. Think for a moment what happens to someone who wishes to report a doctor who asks for money. First, they won’t get the treatment they need, and they may have an urgent medical problem, and then, if their identity is leaked, word about them spreads like wildfire, and no medical personnel at that hospital will want to treat them — and it may be the only government hospital or clinic in town. So people usually shut up and pay up, because they want to get on with their lives, not cause problems for themselves and for others.

Until the problems of corruption and salaries and public healthcare infrastructure get resolved, I would encourage people to use private healthcare options, if they can afford it. The more people use private healthcare, the more affordable and accessible it will get over time, and the more incentive there will be for the government to fix public healthcare.