How do people explain their attitude towards informal payments? The study among a small group of patients seems to confirm previous findings by showing that patients pay out of fear of what might happen if he or she does not pay, or because they hope receiving better or faster treatment. Furthermore, many participants suggested that they engage in paying or offering gifts and services because they believe that due to the current state of affairs (low salaries of the medical personnel, lack of funds), there is no other way to receive the services they need. Study of participants’ attitudes suggests that they realize that offering a bribe to the medical personnel is an expression of bad mentality. Even though services are supposed to be free of charge, because they already pay insurance, participants claim that patients are not being cared for unless they or their acquaintances will offer the doctors or nurses something. They thus realise that engaging in some kind of bribing or gifting behaviour is necessary, even when it is seen as unacceptable, out of fear of not receiving (good) treatment.That is from a paper by Andrada Moldovan and Steven Van de Walle.