DECISION No 32 OF NOVEMBER 26, 1998 ON CC No 29/98
The Constitutional Court’s decision dismissed a challenge of 52 Members of the 38th National Assembly of the constitutionality of Art. 37 para 1 subparas 1 and 2 and of Art. 41 subpara 3 of the Health Insurance Law (HIL) - Darzhaven Vestnik, No 70/1998.
Art. 37 para 1 subparas 1 and 2 require from the compulsory insured persons to pay sums that are a percentage of the national minimum salary to the medic who treats them.
Art. 52 para 2 of the Constitution lists the financial sources of health service. The list is followed by “other sources” that are subject to a law together with the conditions and procedures for raising such needed funds. Although small, sums under Art. 37 of the HIL are to be counted among “other sources” which are to be defined by the Constitution.
In compliance with Art. 52 of the Constitution the Health Insurance Law reads that all Bulgarian citizens who pay contributions in proportion to their earnings shall be covered by the National Health Insurance Scheme. This creates a social health protection system with maximum access to medical care and equal availability for all.
The obligation to pay the sums pursuant to Art. 37 para 1 subparas 1 and 2 of the HIL does not affect the Constitution principles which guarantee access to health service. The needed medical care, medicines and services during treatment are determined solely by the health status and the nature of the disease and not by the amount of contributions.
On Art. 27 para 2 of the HIL. It excludes all persons who cannot afford to pay the sums required by Art. 37 para 1 and thus their access to medical care is restricted. The health insurance contributions of people with financial difficulties shall be covered by the national or municipal budgets.
Art. 41 para 3 of the HIL requires from an insured member of the family with higher income to pay the health insurance contributions for the minors, underage and non-working members of the family if they have not signed up as unemployed. Protection of the family and children is a fundamental principle contained in Art. 14 of the Constitution. The State is not expected to cover all expenses of children. Art. 47 para 1 of the Constitution reads that the raising and upbringing of children shall be a right and obligation of parents. Priority is given to the parental function and the State only assists. Therefore it is not in contravention to the Constitution to make parents pay the health insurance contributions of the minor and underage members of the family.
