The first step toward getting rid of bribery may be to legalize it. Romania could soon try that controversial approach with its underfunded health care system. For the many countries without the money to finance modern public services, or the political will to privatize them, it will be an important case to watch.
Romania is one of the European Union’s most corrupt countries, according to Transparency International. Informal payments seem to be especially widespread in health care, with about a quarter of Romanians reporting that they’ve recently been asked for a bribe by a doctor or nurse. A recent court decision declared gratitude payments to doctors illegal, because the medics are government employees. Subsequent protests by doctors and nurses forced the government to give them a 25 percent raise in salary, but everyone knows that won’t be enough to stop envelopes from changing hands. So, coming out of the negotiations on August 18, Prime Minister Victor Ponta suggested legalizing the payola on three conditions: It shouldn’t be demanded by the doctor, it should come after the treatment is completed and it should be declared and taxed.
The Romanian Physicians’ Alliance, the doctors’ professional association, condemned the proposal in a Facebook post, saying it wanted the government to offer higher salaries, not legalized bribery. Realistically, though, even with the most efficient management of the health care budget, the Romanian government can only afford to pay doctors what academics call a “capitulation wage.” The term refers to salaries so low that they imply employees must supplement their income with direct, informal fees for their services.