Originally appeared in the magazine ' 22 '

A reform is even better, as it involves smaller changes of the existing rules, changes that have, however, a maximum positive effect. Health system shows us, from this point of view, as an exemplary case. The reform proposed by Tariceanu's Government, privatization of hospitals, could not be applied not so because it would have been bad, it was excellent, but because she is too sudden and radical change. It is possible, though, and a different type of reform that would have immediate beneficial effects, and possibly then would pave the path to privatization of hospitals, though not necessarily.
Instead we focus attention on medical service providers, it is preferable to look at health insurance. Reform that I have in mind has two steps:

1. To be allowed private medical service providers, be they hospitals, clinics or private savegames, realizing the State system of medical insurance. In this way, all those who do not work to black in Romania will have access to compulsory health insurance, thanks, to all medical services available, whether provided by State or private environment. If some of the services offered by the private sector will have a price which exceeds the amount of medical insurance, the patient will be able to pay the difference-instead, the current case also to be forced to pay the entire value (such as uninsured). In other words, anyone can go to a private clinic, at present, the privilege of the rich and pay there with medical insurance from the State.
The effect of this reform will be the volume of medical services provided by private providers, instead of the State, will increase gradually, as medical companies will take advantage of the opportunity created. Unlike a sudden privatization, medical system and thus ensure a gradual transition: doctors from the State will not be out, but the best of them will migrate towards the private sector, thanks to higher salaries there. Also, by keeping the State system will not take place in any area of the country, no matter how poor she is, a decrease in the quality or volume of medical services available to the current level, but only an increase, as private companies take over the initiative. The competition between these companies, as happens in all branches of economy, will lead to a decrease in the price of medical services, combined with an increase in the quality of the bid, as opposed to the State being obliged to perpetual innovation to be able to survive on the market. Also, unlike the case of privatization, there will be no question of corruption and trafficking of influence, neimplicandu State in deciding winners in the market of medical services (will be a simple supplier upon supplier that also, for obvious reasons, is expected to lose ground gradually, in damages to private actors).
Until now, it was thought that the health system cannot be reformed than a "strong" character and uncompromising, the kind of Eugen Nicolaescu, to do the right thing and to defend the interests of citizens, making it somewhat regardless of existing interest groups (such as trade unions). This type of image should be replaced with other Hercules Hercules: the one who cleaned stables Augias using his intelligence. Romanian medical system is also his stables, Augias have been cleaned of decades. The solution is not to find a brilliant manager who somehow succeed to build the King of Elis a sewerage system. The solution is to turn to a force of nature beyond any ability has the most brilliant manager and a nudge towards the desired results. In our case, raul to be diverted him to clean out the stables of the Romanian medical system is the market economy. As his stables could be cleaned Augias in "miraculous" in just one day, all the same, free competition mechanism could resolve many of the problems of the current health system much faster than all statist bajbaielile management (no matter how well intentioned they are).
Health system that would ensue as a result of the operation of this reform would not be original, but it would be similar to the health system in France, where the State medical insurance are, while medical providers are almost all private. The disadvantage of this system is that there is a tendency on the part of people to abuse the medical insurances, appealing to all sorts of medical procedures are very expensive, even if you don't get everything needed are. After a few decades, this is felt as a burden on the State budget neignorat. For this reason, the system of medical insurance in France can be found today on a spiral of deficits and financial problems increasingly larger.

2. The second stage of reform is to give citizens the right to abandon the State medical insurance in favor of some private. Currently, people can make private medical insurance, but can't give up state insurance. The consequence is that only the richest have access to private insurance services, ie those who afford to pay two insurance services (even if you only use one). Again, the best way of reform is not to privatize state insurance system, with all the endless discussions that would result in any concrete way about, but is to allow private companies to enter the market of medical insurance and make State competition.
This reform would not, perhaps, as in the previous case, the gradual replacement of State insurance with private ones, because the State will be able to withstand higher losses, but, unlike the case of France, will offer the possibility of a Government responsible to foot the tax threshold and to set a limit of the procedures covered from insurance. In France, where there is no alternative to providing State Government can't do something than really hard, because such a restrictive measures are seen as a denial of the right to medical service.
This kind of system, that would result after the implementation and step 2, there are in a certain extent Germany. In Germany, those who earn more than 4,000 euros per month (i.e. 20% of the German population) have the option to give up completely to the public insurance system and to apply only to private insurance companies. This creates a high enough competition, forcing the public to respond through an increase in efficiency (reductions)-which is why Germany has no problems in France. Condition of 4,000 euros per month represents of course a mistake that we did not institutional needs to replicam. Everyone should have the right to appeal to any company or insurance plan. The reason for the health insurance system from Germany doing better than in France is increased economic freedom and liberties imposed arbitrary limits this. Furthermore, the limitation of the system is at least morally dubious, given that allows output just the rich who, like Romania, actually have the least need it.
System which would arise as a result of two reforms would not be entirely private, but it begins to look hard enough already with him. Storage and system health state (much diminished and we believe that the ultimate measure of aid) is not taken into account economic considerations here (otherwise, nor is there any economic justification is valid for it), but the idea that we are still wealthy enough to afford us a certain level of economic inefficiency in the name of solidarity with those less fortunate or more lazy like us.
In conclusion, health reform would entail, in principle, the effort smaller than it typically entails. Minister Health ought not to assume managerial tasks of a non-existing difficulty, but to settle with the promotion of second-level rules changes: first, to allow private providers of health services to make contracts with the State insurance system; and, secondly, to discuss with the Minister of finance for the development of a system to make it possible in favour of opting for private insurance instead of State (option to become available to anyone). The adoption of this relatively simple reforms we would bring in the situation to have a health system, and if it would be allowed to bring fruit, it is envisioned that in 10-20 years we get to have one of the best health systems in the world, that idea now seems downright science fiction.

Acknowledgments: this article has been substantially, the discussions that we've had with Stefan Eugene.
References: comparative studies of health systems in Europe, see Valentin Petkantchin articles from Molinari Institute from Belgium. Conclusion the german health system superioritatii the face of the French and the French compared to others, such as the British (who looks a lot like the Romanian current), and institutional reasons of this superioritati is taken from his studies.