Macedonia is vulnerable to economic developments in Europe – due to strong banking and trade tire – and dependent on regional integration and progress toward EU membership for continued economic growth. At independence in September 1991, Macedonia was the least developed of the other reading republics, producing a mere 5% of the total federal output of goods and services. The collapse of Yugoslavia ended transfer payments from the central government and eliminated advantages from inclusion in a de facto free trade area. An absence of infrastructure, UN sanctions on the downsized Yugoslavia, and a Greek economic embargo over a dispute about the country’s constitutional name and flag hindered economic growth until 1996. Since then, Macedonia has maintained macroeconomic stability with low inflation, but it has so far lagged the region in attracting foreign investment and creating jobs, despite making extensive fiscal and business sector reforms. Official unemployment remains high at more than 30%, but may be overstated based on the existence of an extensive gray market, estimated to be more than 20% of GDP, that is not captured by official statistics. In the wake of the global economic downturn, Macedonia has experienced decreased foreign direct investment, lowered credit availability, and a large trade deficit. However, as a result of conservative fiscal policies and a sound financial system, in 2010 the country credit rating improved slightly. Macroeconomic stability has been maintained by a prudent monetary policy, which keeps the domestic currency pegged against the euro. As a result, GDP growth was modest, but positive, in 2010 and 2011.


Health care  cost represents 8.2 percent of the Macedonian GDP. Government health expenditure represents about 66.5 percent of total health funding. Out of pocket expenditure makes up nearly all of private health care spending, as local private health insurance is nearly nonexistent, and it is forbidden to opt out of the state system. Doctors may treat private and public patients, although treatment from doctors not registered with the state system may not be reimbursed by the Macedonian Health Insurance Fund.

Macedonia has long provided universal emergency care to all citizens. In 2009, it added free universal primary health care to all citizens and registered foreign residents. This is in line with the Macedonian Constitution, which has a provision on ‘coverage and protection of the health of all citizens’. Macedonia’s universal health care covers unlimited visits to primary care physicians, treatment from specialists, hospitalisation, basic dental treatment, pregnancy and childbirth as well as treatment overseas if necessary. Emergency treatment, including ambulances, is available to everyone in Macedonia, best mail order bride service even those not registered with this state health care system.

Persons employed in Macedonia must make mandatory contributions of 0.5 percent of their gross annual salary to the Health Insurance Fund of Macedonia. The costs of prescription medicines are reimbursed, although a 20 percent co-pay may be required. All major Macedonian cities and towns have adequate hospitals and health care clinics; those patients covered by state insurance will generally have to share a room with two to three other patients. Most pharmacies are also state-run and subsidised, making the cost of prescription drugs actually lower than over the counter drugs in some cases.

Its state-run health care system is modelled after the British National Health Service, and aims to provide reasonable and universal coverage to all. While Macedonia has achieved much success in this aim, staff shortages due brain drain and grey market pharmaceutical sales have diluted the level of care provided in the country. Some medical issues and emergencies may require levels of private care which require top-up insurance coverage in country; more serious cases may require evacuation and transport to one of the EU member states. Hence, travel insurance to cover this contingencies should be arranged before embarking on a trip to Macedonia.