HEALTH SYSTEMS IN TRANSITION IN CENTRAL AND EASTERN EUROPE

Abstract

On 1 May 2004, eight former communist countries of Central and Eastern Europe joined the European Union (EU). This created a range of challenges for health policy in the new member states. On top of issues relating to the health of their populations, their economic situation, and the changing nature of healthcare that affects all countries, the process of acceding to the EU requires them to adhere to the accumulated body of European law, some of which has implications, directly or indirectly, for health policy. This paper examines these challenges and the responses being developed to them. While the countries have much in common, in particular the shift from the former model of healthcare financing to a more pluralistic model, often based on health insurance, there is also considerable diversity, as each is using different policy options to achieve the same broad objectives. While these countries have much in common, not least the experience of EU accession, they also have considerable flexibility to pursue the systems that they choose. The challenge is to enable a process of mutual learning without imposing a single, homogenous model that ignores their important differences. In doing so, they should not just look to the systems of healthcare being adopted by their neighbours in this region and to the models existing in the countries of Western Europe, but instead should be looking to the systems that they will have to put in place to meet the specific health needs of their own populations, which are different from those in other parts of Europe, as well as to meet the challenges of the future.