Health 2025: Romanians paid 130 billion RON, over a quarter directly out of pocket

Healthcare expenditure in Romania has reached nearly 130 billion RON this year, equivalent to 6.7% of GDP. The figures come from the study "Transparency of Funds in the Romanian Healthcare System", carried out by the Academy of Economic Studies (ASE) in partnership with the private healthcare network Regina Maria – the second edition of this analysis.

According to the study, Romanians support the funding of the healthcare system in two ways, and their direct and indirect contributions account for approximately 80% of all annual healthcare spending:

• through the mandatory contribution of 10% of gross income to the social health insurance fund (CASS);
• through direct out-of-pocket payments for medical services or medicines not covered by the public system.

In concrete terms, CASS contributions brought approximately 65 billion RON into the system, accounting for 51% of the total healthcare budget for 2025. Direct patient payments, also known as out-of-pocket payments, amounted to over 33 billion RON, representing 26% of total funding.

The remainder of the funding comes from other sources: the Ministry of Health's budget contributed 12 billion RON, health subscriptions (corporate or individual) contributed 1.4 billion RON, and private health insurance contributed just 630,000 RON.

The study also shows that hospitals and medicines consume nearly 80% of the entire system's resources, whilst outpatient services (consultations and investigations outside of hospital admission) receive only around 20% of funding. Although outpatient funding has grown more rapidly than hospital funding in recent years, the system remains primarily oriented towards treating established illness rather than prevention.