Health Reforms In Post Communist Eastern Europe

This book provides the first in-depth study of healthcare reforms in post-communist Eastern Europe. Combining insights from comparative politics and public policy analysis, it examines health reforms in Slovenia, the Czech Republic, and Poland between 1989 and 2019. The book argues that the post-communist transformation of healthcare policy has entailed a process of policy learning, and that the countries' reform pathways were shaped by a series of initiatives aimed at applying market-oriented policy ideas in healthcare. The success of these initiatives has been influenced by three factors: policy legacies, political competition, and institutional configurations. The book offers a novel comparison of health reform in the region and policy changes more generally. It will appeal to scholars and students of public policy, health policy, and European politics.

Health Politics in Europe: A Handbook is a major new reference work, which provides historical background and up-to-date information and analysis on health politics and health systems throughout Europe. In particular, it captures developments that have taken place since the end of the Cold War, a turning point for many European health systems, with most post-communist transition countries privatizing their state-run health systems, and many Western European health systems experimenting with new public management and other market-oriented health reforms. Following three introductory, stage-setting chapters, the handbook offers country cases divided into seven regional sections, each of which begins with a short regional outlook chapter that highlights the region's common characteristics and divergent paths taken by the separate countries, including comparative data on health system financing, healthcare access, and the political salience of health. Each regional section contains at least one detailed main case, followed by shorter treatments of the other countries in the region. Country chapters feature a historical overview focusing on the country's progression through a series of political regimes and the consequences of this history for the health system; an overview of the institutions and functioning of the contemporary health system; and a political narrative tracing the politics of health policy since 1989. This political narrative, the core of each country case, examines key health reforms in order to understand the political motivations and dynamics behind them and their impact on public opinion and political legitimacy. The handbook's systematic structure makes it useful for country-specific, cross-national, and topical research and analysis.

Examines the social causes of the decline in life expectancy in Russia and Eastern Europe. Countries discussed include Russia, Poland, Hungary, Romania, Bulgaria, the Czech Republic and East Germany.

Reform of the welfare sector is an important yet difficult challenge for all countries in transition from socialist central planning to market-oriented democracies. Here a scholar of the economics of socialism and post-socialist transition and a health economist take on this challenge. This 2001 book offers health sector reform recommendations for ten countries of Eastern Europe, drawn consistently from a set of explicit guiding principles. After discussing sector-specific characteristics, lessons of international experience, and the main set of initial conditions, the authors advocate reforms based on organized public financing for basic care, private financing for supplementary care, pluralistic delivery of services, and managed competition. Policymakers need to achieve a balance, both assuring social solidarity through universal access to basic health services and expanding individual choice and responsibility through voluntary supplemental insurance. The authors also consider the problems that undermine effectiveness of market-based competition in the health sector.

Given dramatic changes in Central and Eastern Europe since the fall of the Berlin Wall 1989 and the dissolution of the Soviet Union in 1991, local area experts were challenged to examine their national systems of health care, as well as proposals to reform them. Each chapter of this book provides contextual data and information on the empirical realities of a specific country at five-year intervals since 1990, as well as the organizational framework of its health care system. The book explores the historical thread of the reforms attempted and their current state of implementation by addressing criteria for reforming national health systems such as costs, effectiveness, efficiency, equity, and feasibility. The book stresses selected policy elements, such as the roles of major actors, the shadow economy, cost containment, access, centralization, and decentralization. While no blueprint is offered, intriguing patterns emerge across the cases, plus observations about 'next steps' in the unfolding process of health reforms in the region.

This book presents a novel view of healthcare system transition in post-communist countries. It is the first region-wide comparative study of hospital governance in Eastern Europe. Comprehensive new material shows the evolution and significance of governance, complementing recent publications on the topic from industrialised countries. Throughout the book, governance is described and substantiated as a major component that, together with provider payment mechanisms, defines the hospital sector’s operations. This view subscribes to the economists’ growing appreciation of extra-financial aspects in the discussion of incentives and regulation of healthcare markets. In particular, the book explains how governance arrangements may affect the outcomes of healthcare financing reforms, and should thus be seen as a critical determinant of their success or failure. This new model of thinking about healthcare system transition emerges from an analysis of 22 countries over the course of two decades. While the primary focus of the study is on developing the hospital sector, an extensive background chapter provides a standalone introduction to the dynamically changing landscape of healthcare in Eastern Europe and an overview of the various problems and challenges the region is facing. Practitioners, policy-makers, academics and students interested in Eastern European healthcare systems, their origins, current status and ways forward, will appreciate the book’s reflections on the problem complexity, the clarity of its concepts, and its accessible style of presentation.

Annotation World Bank Technical Paper No. 293.Presents a conceptual framework for understanding the impact of health sector reforms in Central and Eastern Europe. The book analyzes the various factors involved in the reforms and presents strategies adopted by many countries of the region during the early phases of the transition era.

This ground-breaking new volume focuses on the interaction between political, social, and economic change in Central and Eastern Europe and the New Independent States. It includes a wide selection of analytic papers, thought-provoking essays by leading scholars in diverse fields, and an agenda for future research. It integrates work on the micro and macro levels of the economy and provides a broad overview of the transition process. This volume broadens the current intellectual and policy debate concerning the historic transition now taking place from a narrow concern with purely economic factors to the dynamics of political and social change. It questions the assumption that the post-communist economies are all following the same path and that they will inevitably develop into replicas of economies in the advanced industrial West. It challenges accepted thinking and promotes the utilization of new methods and perspectives.