The Republic of Moldova introduced substantial reforms to its health system in 2004 with the
establishment of a mandatory system of health insurance, and a single pool of funds combining
both payroll contributions and budget transfers. Under this system, however, around one-quarter
of the population makes no insurance contribution, and hence has very limited financial risk protection
when accessing health services. The subsequent National Health Policy 2007–2021 clearly
articulated the goal of ensuring equal and adequate access to health services for all citizens of the
Republic of Moldova, and this report recommends three possible courses of action to the Minister of
Health to move towards this goal given the country’s current fiscal capacity; first to use insurance
subsidies in a more poverty-focused way, secondly to strengthen various aspects of the design and
management of the insurance programme, and thirdly to strengthen the link between citizenship
and entitlement to health care.