Welfare, Choice and Solidarity in Transition
Reforming the Health Sector in Eastern Europe

Two scholars offer health sector reform recommendations for ten countries of Eastern Europe.

János Kornai (Author), Karen Eggleston (Author)

9780521159371, Cambridge University Press

Paperback, published 9 December 2010

380 pages
21.6 x 14 x 2.2 cm, 0.48 kg

Review of the hardback: 'The authors' intrinsic knowledge of the political economy of transition countries, their profound understanding of the historic context of the region, and their comprehensive approach to this rather complex topic make the work especially valuable for decision-makers and opinion leaders in Europe. In this context, the book fills a considerable void.' Health Affairs

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.

Part I. Points of Departure: 1. The general principles of reform
2. The characteristics of the health sector
3. Some international experiences
4. The health sector in Eastern Europe: the initial state
Part II. Guidelines for Reform: 5. The demand side: financing, benefits, and organization of insurance
6. The supply side: delivery system ownership, organization, and contracting
7. The interaction of supply and demand: pricing, payment, hard budget constraints, and overall health-sector development
8. Concluding remarks.

Subject Areas: Health systems & services [MBP], Public finance [KFFD], Economics [KC], Political structures: democracy [JPHV], Welfare & benefit systems [JKSB]