Lithuania

2021 ◽  
pp. 456-472
Author(s):  
Liubovė Murauskienė

This chapter examines health politics and the compulsory health insurance system in Lithuania and traces the development of its healthcare system. Since the country declared independence from the Soviet Union in 1990, Lithuanian health politics have revolved around restructuring and rationalizing the overcapacities of the inherited healthcare system, increasing levels of public finance to those sufficient to meet healthcare needs, and making good on the patient rights implied by a universal system. Despite those efforts, high out-of-pocket payments remain an obstacle to health solidarity, healthcare provision—which is predominantly public—is overly dependent on inpatient care, and public financing measured as a share of GDP remains low. As the chapter outlines, other issues include low levels of satisfaction with and trust in the health system and the persistence of informal payments to ensure quality care.

2019 ◽  
Vol 29 (2) ◽  
pp. 243-247
Author(s):  
Aleksandr G. Chuchalin

This article is devoted to a remarkable data, the 90th anniversary of Academician of Russian Academy of Science, Hero of Socialist Labour of the Soviet Union, Evgeniy I. Chazov. His multifaceted personality has been formed under an influence of Dmitriy D.Pletnev, who founded of a Russian therapeutic school at the middle of 20th, the 20th century. Evgeniy I. Chazov is known not only as a scientist and a physician, but also as a talented public health manager. He was at the head of Healthcare Ministry of Soviet Union from 1987 to 1990. Under his leadership and with his direct participation, the Soviet healthcare system acquired novel modern features: a network of diagnostic centers and pediatric healthcare facilities was organized that led to decrease in child mortality, healthcare provision in extreme conditions, development of control measures against human immunodeficiency virus, and updating the legislation on psychiatric care. Novel business principles were implemented in the country by Evgeniy I. Chazov; high tech diagnostic equipment was supplied to medical institutions.


2021 ◽  
pp. 683-722
Author(s):  
Tamara Popic

This chapter provides an extended look at health politics and the universal health system based on a compulsory social health insurance in the Czech Republic. It traces the historical development of the Czech healthcare system, characterized by a systemic shift from an insurance system to a fully state-run Soviet Semashko model of healthcare provision. Since the fall of communism in 1989, the Czech healthcare system has undergone significant reforms, including a return to a Bismarckian insurance system and market-oriented reforms in delivery and financing of health services. The post-communist reforms were characterized by the crystallization of the left–right political divide in healthcare policymaking. As the chapter argues, this division became particularly pronounced in the context of reforms introducing user fees for medical services and hospital privatization, both of which were controversial issues, with critics arguing that these reforms posed a major threat to the system’s solidarity.


2021 ◽  
pp. 767-787
Author(s):  
Tamara Popic

This chapter offers an in-depth look at health politics and the health system in Slovakia based on compulsory social health insurance. It traces the development of the Slovak healthcare system, characterized by the shift from a social health insurance model to a Semashko model of health provision under communism. Slovak post-communist health politics has been marked by strong left–right political conflict and institutional barriers to reforms. Nevertheless, health policy in Slovakia displays a dramatic shift to a market-oriented healthcare provision based on user fees and managed competition, introduced in 2003 and 2004. Attempts to reverse market-oriented reforms were partially successful and have involved supranational and international authorities of the European Commission and of the International Court of Arbitration. As outlined in the chapter, some of the main issues facing the Slovak healthcare system have been overcapacity in the hospital sector, a malfunctioning referral system, and corruption.


2018 ◽  
Vol 17 ◽  
pp. 51-87 ◽  
Author(s):  
Aistis Žalnora ◽  

Objective: During the interwar period, the healthcare system in Europe experienced a dramatic transformation. It was perceived that preventive medicine was no less important than curative medicine. Moreover, without proper prevention of the so-called social diseases, all later therapeutic measures were expensive and ineffective. The former battle against the consequences was replaced by measures targeting the causes. The fight against social diseases involved a state-owned strategy and a broad arsenal of measures. The University’s scholars also took part in this process. Our study revealed that the significance of the disease prevention in the Faculty of Medicine at the University of Stephen Bathory was well understood. Moreover, the treatment was not segregated from hygiene as strictly as it is today. Many hygienists as well as clinicians contributed to the development of preventive mechanisms. The broad specialization of doctors enabled them to see not only biomedical, but also social and economic aspects of a disease. Hygienists and doctors encouraged cooperation and coordination of their activities with the central and local authorities as well as education of the local population. The progress of medical science in Europe and the World, as well as the Soviet ideology in Eastern Europe distracted doctors from the search for the etiology of social illness. Biomedical treatment had become much more effective, and the development of social hygiene research in Eastern Europe had experienced stagnation. For ideological reasons the disease etiology in the Soviet bloc could not be associated with social factors. Social hygiene in the Soviet Union was highly politicized; it could only be interpreted in a frame of Soviet models. The healthcare system that had been created in the Soviet Union was named as the best in the world. The actual medical statistics were concealed from the public, since their logical interpretation could reveal the social causes of illnesses and the disadvantages of the soviet system. Sometimes we must return to basic ideas to improve current public health mechanisms. It is worth reconsidering fundamental questions, i.e. what public health is and how to achieve it. The breadth of the approach of the interwar Vilnius hygienists and doctors, the sensitivity to the social origins of diseases and persistence in combating them by all possible means could serve as an example for today’s doctors. At that time, hygienists approached the idea that the highest goal of prevention was to create a healthy environment, healthy living and working conditions. Although today we live in a much safer environment than those individuals did, new threats are emerging because of changing technology and lifestyle. The broad approach of physicians remains equally important in order not only to combat individual precedents, but also to overcome the preconditions for emerging precedents. Therefore, the purpose of this paper is to reveal the theoretical patterns of hygiene and public health established by the hygienists of the Vilnius Hygiene Department as well as the attempts to apply them in practice. Methods: The study was conducted by analyzing the primary and secondary historical sources using the comparative method. A lot of data from the Lietuvos Centrinis Valstybės Archyvas (Lithuanian Central State Archives) that had been used in this research were published for the first time. According to the original archival data, an analysis of the scientific publications of the Faculty of Medicine of the University of Stephen Bathory was made to find out the priorities of the research carried out at that time. Conclusions: The complicated economic conditions, the lack of support from the local and central government as well as the imperfections in health legislation of that time hindered the full implementation of the hygienist strategies of the University of Stephen Bathory. However, the activities of the Department of Hygiene of Stephen Bathory University had a significant impact on the development of hygiene science as well as medical practice in the Vilnius region during the Interwar period (1919–1939).


Author(s):  
Elena Frolova

The Baltic countries have always occupied a separate position among other Soviet republics, differing from them not only in language, but also in their worldview, cultural values, mentality and religion. After the collapse of the Soviet Union the reform of the healthcare system in these three states (Estonia, Latvia, and Lithuania) took place according to a similar scenario — from a centralized health care system to insurance medicine, but at the same time it had a number of peculiarities. We can consider health care system of Estonia, a small state with a population of only 1.3 million people, as the best model showing results of the health care system reorganization.


2019 ◽  
Vol 5 (2) ◽  
pp. 7-17
Author(s):  
I. G. Mosyagin ◽  
L. N. Gorbatova ◽  
I. M. Bojko ◽  
E. V. Kazakevich

The paper deals with the guidelines for centres of marine medicine, training and accreditation systems for specialists in the area of marine medicine. It was observed that the ratification by Russia in 2012 of the International Labour Organization Convention No. 186 «On Labour in Maritime Navigation» of 2006 and delegation by the Government of the Russian Federation the authorities to comply the requirements of this Conference by the Russian Federation on the Ministry of Healthcare of the Russian Federation set the tasks of improvement of legal and regulatory framework of the marine cluster of the National Healthcare System and its integration into the International Marine Healthcare System. The Russian Federation has wide and positive experience of a medical support of the seafarers of the Soviet Union. The experience of organizing the activities of international medical centers and training and accreditation medical systems for specialists in the area of marine medicine will be useful for development of national medical support system of naval capacity of the state.


2018 ◽  
Vol 31 (4) ◽  
pp. 83-106
Author(s):  
Aleksandra Brokman

This article explores the concept of minor or general psychotherapy championed by physicians seeking to popularise psychotherapy in the post-Stalin Soviet Union. Understood as a set of skills and principles meant to guide behaviour towards and around patients, this form of psychotherapy was portrayed as indispensable for physicians of all specialities as well as for all personnel of medical institutions. This article shows how, as a result of Soviet teaching on the power of suggestion to influence human organisms, every interaction with patients was conceptualised as a form of psychotherapy, leading to the embrace of placebo as a legitimate form of therapy, and to the blurring of the boundary between therapy and other activities in the clinic. The principles of minor psychotherapy reveal a concept of psychotherapy that is much wider, and rooted in different priorities, than the dominant understanding of this type of treatment found in Western Europe and North America. This article addresses the ethical principles implicit in the Soviet perspective, demonstrating that despite fighting against the uncaring and dismissive attitude of other physicians, Soviet psychotherapists remained rooted in the paternalistic tradition. Finally, it traces the efforts to establish minor psychotherapy as standard practice in medical institutions, which, like many other plans and ambitions of Soviet psychotherapists, were constrained by a lack of resources in the healthcare system.


2003 ◽  
Vol 36 (4) ◽  
pp. 405-426 ◽  
Author(s):  
Jolanta Aidukaite

This paper compares the system of social maintenance and insurance in the Soviet Union, which was in force in the three Baltic countries before their independence, with the currently existing social security systems. The aim of the paper is to highlight the forces that have influenced social policy transformation from its former highly universal, however authoritarian form, to the less universal, social insurance-based systems of present day Lithuania, Latvia and Estonia. It will be demonstrated that the welfare–economy nexus is not the only important factor in the development of social programs. Rather, social policy should be studied as if embedded in the political, historical and cultural aspects of a given society. The people’s attitude towards distributive justice will be highlighted as being one of the most important factors for either social policy shortcomings or expansion. This paper takes steps to combine quantitative and qualitative data.


Author(s):  
Evgeny Yurievich Baranov

The goal of this article consists in determination of the key vectors and results of historical research dedicated to epidemic situation in the Soviet Union during the 1930s at the present stage of development of Russian historiography. Its relevance is substantiated by profound understanding of historical and modern trends in development of epidemic processes, as well as assessment of historical experience in the fights against epidemics. The epidemic situation in the Soviet Union during the 1930s has not previously become the subject of separate historiographical analysis. Two key vectors are determined: the first is  associated with conducting historical-demographic research; while the second in related to research on the history of establishment and development of Soviet healthcare system. It is demonstrated that the results of historical research consist in outlining the political, socioeconomic, and environmental factors of epidemic morbidity, as well as positive and negative trends in the development of healthcare system, quantitative characteristics of morbidity rate, role of infections within the structure of mortality. Historiography assesses the level and resource capacity of healthcare system, analyzes the epidemics preventive measures, characterizes the role of epidemics in the advent of demographic crises, and describes their negative impact upon the processes of demographic modernization. The conclusion is made on transformation of the approaches towards historical-demographic research: from determination of demographic crises, the scholars shifted to historical generalizations, analysis of morbidity and mortality rates based on the concept of “epidemiological transition”. The acquired results demonstrate that the development of healthcare system was based on consideration of the experience of population losses caused by epidemics, and despite the shortage of resources. In the fight against epidemics, efforts were concentrated on the preventive measures, the effective instrument of which was vaccination of population.


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