Financing Health Care: What Can we Learn from CEE Experience?

Abstract

Our paper is based on four country samples - Bulgaria, Czech Republic, Slovakia and Slovenia. All these countries are new EU member states, where the (official) goal of the health-finance system is to guarantee universal and equal access to health services. In the first part the country studies describe the evolution of new health-finance systems in selected countries as well as the pros and cons of national solutions. The core part of this paper discusses two important health-financing issues - the decision about how to fund health services and particularly the decision about the relations of public and private funding of health care. We propose two core conclusions: first, because the mode of financing does not have a clear impact on outcomes of the health-care system, the decisions of CEE countries to switch from general taxation to social-insurance systems are based mainly on political rationality; second, introducing pluralistic social health insurance during early phases of transition is too risky.