16 September

13.00 hrs

Bilateral meetings on structural funds

24 September

08.30 hrs

Breakfast meeting with Secretary of State Mr. Bogdan Dragoi

29 September

18.00 hrs

Cocktail drink with trade mission ornamental plants

7 October

19.00 hrs

Looking to my company through the eyes of a bank

28 October

17.00 hrs

Public Healthcare in Romania

25 November

19.00 hrs

Practical insight in the Romanian VAT/tax system for small entrepreneurs

16 December

08.00 hrs

Breakfast meeting on Economic Perspectives

Public Healthcare in Romania

Sponsored by: Merck Sharp& Dohme

Wednesday, 28 of October 2009 the Public Healthcare in Romania seminar took place at McMoni’s.

The speakers of the seminar were:

Mr. Catalin Popa, CEO at Euroclinic

Mr. Peter Oostveen , GM at Architectural Group

Mr. Hans Pollmann , CFO at Merck Sharp& Dohme Romania

Presentations:

1. Romanian Healthcare system

by Catalin Popa

In his presentation Mr. Popa brought the attention on the fact that Romania is on the 32^nd place from 33 countries in Europe, barely in front of Bulgaria.

And the situation doesn’t seem to get better considering that public health budget is at the lowest point in 9 years with 3% of GDP .

Another major problem in the public health system is consisted in informal payments. In 2008, 60% of the people who paid for hospitalization, made informal payments. This results in 30% of expenditures from the medical services market.

Although now the whole picture of public healthcare doesn’t look very well, the future can bring a real growth and improvement.

As Mr. Popa presented, the steps to a better health plan would be: economic convergence with Europe; cleaning up the grey economy; health reform; health insurance.

Top Ten Trends in Modern Healthcare:

1. Hospitals no longer constrained to buildings

2. Commoditization of healthcare services and introduction of retail healthcare

3. Cyber-health care that is customized for us

4. New players targeting healthcare

5. Focus on patient safety

6. Size and focus

7. Personalized medicine drives the agenda

8. Bio-informatics gets respect

9. Bio-connectivity becomes the next big thing

10. Electronic signature everywhere

The demographics are to be considered as Romania’s population is getting older, a lot of people suffer from chronic diseases, immigration has a high rate, and doctors are leaving the country to work abroad.

Mr. Popa’s presentation ended with a “here and now” overview:

· Private hospital plans shelved for now

Out of 5 known organic projects, only one is still moving according to plans, though delayed also.

· Consolidation of existing private players, less organic growth in 2010

Doctors organizing together in micro corporations and contracting out their services, or starting up medium size organizations

· Inertia in public system will continue to fuel private environment and will push clients out according to purchasing power

· New development through greater private equity activity

Economic resiliency of healthcare providers have caught the attention of corporate investors.

Early financers cashing out, making room for second round, with or without exits of the initial entrepreneurs. At least three large scale private providers are for sale.

· Select specialties poised for growth

Less likely to have large scale infrastructures, but likely to have niches specialty hospitals focused on areas such as cardiology, orthopedics & pediatrics.

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2. Public healthcare from a doctor’s view

by Peter Oostveen

Mr. Oostveen approached the problem of public healthcare from a doctor’s perspective.

The badly distributed low budget, the frequent changes of the Minister of Health and straightly said, the indifference of the Romanian Government are the main issues in the present situation of the public healthcare system.

The hospitals have a bad architecture and a poor infrastructure. The equipment is old especially in the hospitals outside Bucharest or big cities. And which is worse, in Romania only three hospitals are accordingly to European standards.

The communication inside the system also lacks in organization, and informal payments are at a very high level, which can’t bring any improvement.

Mr. Oostveen’s solution for the future is the construction of a polyclinic with all the medical specialties, accessible to everybody, but with a period of hospitalization no longer then two days. For more serious problems the patients will be sent to hospitals.

Of course the idea of such a polyclinic is very good and will be profitable for everybody on long term, but who will finance it? Well, the money should come from the state and population contribution.

The public healthcare system should function better if the hospitals would collaborate more, including private clinics, in the idea of sharing equipment and information.

3. Pharmaceutical products and the financial side of the coin

by Hans Pollmann

Mr. Pollmann took the stand presenting the subject of public healthcare from a pharmaceutical point of view.

The beginning point of the presentation was that Romania is indeed almost the last one of the European countries when it comes to public healthcare. The total healthcare spend per capita and consumption of medicines per inhabitant in EU27 ranks Romania near the bottom of the consume fot healthcare.

Pharmaceuticals are the necessary preventive treatment to prevent hospitalization. Especially on long term the costs of preventing and early treatment of a disease are lower then treating it at an advance stage or act surgically.

What is happening now in the healthcare system cannot bring any improvement and the future is rather gray.

A very good example is the Government emergency ordinance modification law 95/2006 from 4 October 2009 which has three main implications:
- good for Romanian healthcare budget
- bad for healthcare and patient
- supply system of pharmacies to patients will stop

Mr. Pollmann ended his speech with an example of how economically illogic the Romanian Government acts, presenting the 2001 AIDS treatment case when Merck lowered the medicine price by 86%.

With a steady increase from the Government of the health budget and the low prices of the medication offered by Merck, the volume in sales should go up high. However, this was not the case because the Government decided to buy the drugs from a different company, although at a higher price. Eventually Merck lost the complete HIV market.

The Seminar was very successful as important issues were discussed, the participants were very active in the Q&A sessions after each presentation and interesting points of view were exposed.

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