OBJECTIVES: To investigate the perception of Romanian hospital managers towards under financing of the health sector and to identify the major drawbacks on different aspects of hospital activity. The Romanian hospitals are paid using DRG system since 2009. This is the first attempt to obtain an empiric imagine of the oppinoin of the hospital’s managers  regarding the effect of inadequate financing and its consequences. METHODS: In the last trimester of 2014, we have sent a questionnaire with 25 questions to the top management of every Romanian hospital. The quiz was based on the results of a focus group held in September 2014 which included 7 managers from different hospitals in Romania. RESULTS: In 2013 in Romania there were 435 hospitals contracting services with the social insurance system. The questionnaires were sent by mail and we received 82 answers, which were sent back by mail or completed anonymously in a special online application. 85% (70 of 82) of the managers indicated that the budget negotiated with the social insurance system is insufficient and causes some to major difficulties, some of them saying that is impossible to cover their expenses. As a result, 34,3% of the underfinanced hospitals had difficulties in acquiring the medication for their patients! 22,8% of those said that they faced difficulties in buying the drugs that cost more than 22 Euro per day of treatment. 94% of the managers believed that the official tariffs do not cover the expenses required by the services. CONCLUSIONS: Under financing of the Romanian hospitals is due to the inadequate tariffs established unilateral by the National Insurance House. As a result, many of the hospitals are generating debts. As the wages are paid with priority, the main effect of under financing is an inadequate amount of money spent on drugs.