• Mihaela Onofrei, Elena Cigu, Anca-Florentina Gavriluta Vatamanu, Ionel Bostan, and Florin Oprea.
• Faculty of Economics and Business Administration, Alexandru Ioan Cuza University, 22 Carol I, 700505 Iasi, Romania.
• Int J Environ Res Public Health. 2021 Jan 28; 18 (3).

AbstractThe COVID-19 pandemic stressed the importance of understanding the sources of vulnerabilities that can lead to a financial crisis and highlighted the predominant impact on health systems. Firstly, the paper aims to conduct a retrospective analysis of the Romanian health care system, over the period of time 1985-2019, based on our own computed sustainability index for public health. Secondly, using the Gregory-Hansen cointegration method, we provide new evidence on the causal relationship between health expenditure and GDP for Romania over the period of time 1985-2017. Based on the retrospective analysis of the long-run co-movement between health spending and GDP, the study allows one to prospectively examine not only the effects of the COVID-19 pandemic on health care spending, but also to reveal the government's fiscal position and vulnerabilities. Our results highlight the intergenerational costs related to the policy incoherence roadmap and regulatory fragmentation, stressing the importance of economic system resilience through fiscal diligence and the consolidation of the institutional context.

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