Croatia

2021 ◽  
pp. 908-917
Author(s):  
Tamara Popic
Keyword(s):  
Health Policy ◽  
Health Insurance ◽  
Health System ◽  
Policy Development ◽  
Private Insurance ◽  
Social Health Insurance ◽  
Insurance Fund ◽  
Health Politics ◽  
Insurance Model ◽  
Universal Health

This chapter offers an in-depth look at health politics and the universal health system in Croatia based on compulsory social health insurance combined with elements of private insurance. Since its independence in 1993, Croatia’s health policy has been marked by a move from the Yugoslav self-managed insurance model to a more standard Bismarckian health insurance system. These reforms were combined with controlled efforts to privatize healthcare financing and delivery including, among others, the 2001 introduction of complementary private insurance. While Croatia’s health policy development suggests path dependency, the chapter highlights several issues facing the country’s health system such as hospital debts and the deficit of the national health insurance fund.

Serbia

2021 ◽  
pp. 918-928
Author(s):  
Tamara Popic
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Waiting Lists ◽  
The Self ◽  
Social Health ◽  
Healthcare Provision ◽  
Health Politics ◽  
Insurance System ◽  
Insurance Model ◽  
Universal Health

This chapter offers an in-depth look at health politics and the universal health system in Serbia based on compulsory social health insurance. It traces the development of the Serbian healthcare system after the breakup of Socialist Federal Republic of Yugoslavia, characterized by a move from the self-managed insurance model to a more standard Bismarckian health insurance system combined with passive privatization. Despite efforts to restructure healthcare provision through a reform in 2005, the system’s two-tier structure remains firmly entrenched, protected by professional interests. The chapter highlights other healthcare issues including long waiting lists and corruption.

Slovenia

2021 ◽  
pp. 788-808
Author(s):  
Tamara Popic
Keyword(s):  
Health Insurance ◽  
Primary Care Physicians ◽  
Private Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Party Competition ◽  
Social Health ◽  
Large Hospital ◽  
Health Politics ◽  
Universal Health

This chapter offers an in-depth look at health politics and the universal health system in Slovenia based on compulsory social health insurance. It traces the development of the Slovenian healthcare system from the first health insurance schemes to the more established insurance system with universal coverage and focus on social medicine under communism. Since its independence in 1992, Slovenian politics has been marked by a pragmatic model of party competition with an important role in healthcare policymaking played by neo-corporatist structures. The major post-communist reform was the introduction of complementary private health insurance in 1993, which covers the majority of the population. Several unsuccessful reform proposals sought the abolition of complementary private insurance, the fairness of which remains the most controversial question regarding the system. Other healthcare issues outlined in the chapter include large hospital debt and uneven distribution of primary care physicians.

Montenegro

2021 ◽  
pp. 929-938
Author(s):  
Natalija Perišić
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Healthcare Delivery ◽  
Social Health Insurance ◽  
Social Health ◽  
Healthcare Provision ◽  
Health Politics ◽  
Private Healthcare ◽  
Incomplete Coverage

This chapter examines health politics and the health system in Montenegro based on compulsory social health insurance. It traces the post-communist development of the Montenegrin healthcare system that started with incremental privatization and continued toward a more decisive move toward liberalization through the 2004 reforms, which included, among other elements, a stronger role of private healthcare delivery and the introduction of different types of voluntary insurance. As the chapter notes, the main issues facing the health system in Montenegro are incomplete coverage, limited access to healthcare, and lack of regulation of private healthcare provision.

Slovakia

2021 ◽  
pp. 767-787
Author(s):  
Tamara Popic
Keyword(s):  
Health Insurance ◽  
Healthcare System ◽  
Social Health Insurance ◽  
Political Conflict ◽  
Social Health ◽  
Managed Competition ◽  
Healthcare Provision ◽  
Health Politics ◽  
Dramatic Shift ◽  
Insurance Model

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.

The Netherlands

2021 ◽  
pp. 520-557
Author(s):  
Karen M. Anderson ◽  
Ruud J. Van Druenen
Keyword(s):  
Health Insurance ◽  
The Netherlands ◽  
Party System ◽  
Large Scale ◽  
Private Insurance ◽  
Social Health Insurance ◽  
State Regulation ◽  
Managed Competition ◽  
Health Politics ◽  
Private Actors

This chapter provides an extended look at health politics and the mandated health insurance system in the Netherlands. It traces the historical development of the Dutch healthcare system, analyzing the emergence of a bifurcated public–private system and its replacement with mandated private insurance in 2006. The Dutch case is thus notable for large-scale privatization accompanied by expanding state regulation of private actors. Dramatic shifts in the party system since the 1980s shaped reform processes as the center-left consensus in favor of social health insurance and redistributive financing was replaced by center-right consensus supporting managed competition among private insurers. Reforms adopted since 2005 have aimed to control costs without sacrificing quality, largely by strengthening managed competition and the regulation underpinning it.

Poland

2021 ◽  
pp. 745-766
Author(s):  
Tamara Popic
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Public Hospitals ◽  
Social Health ◽  
Health Politics ◽  
Insurance System ◽  
Out Of Pocket Payments ◽  
Healthcare Politics ◽  
Veto Points ◽  
Universal Health

This chapter offers an in-depth look at health politics and the universal health system in Poland, financed through social health insurance. It traces the development of the Polish healthcare system under communism, characterized by a complete shift from an insurance system to a state-run Soviet Semashko model of healthcare with some elements of private provision. Since 1989, Polish health policy went through systemic changes which included a shift to a decentralized social health insurance system in the late 1990s and re-centralization in 2001. Polish healthcare politics has been turbulent, marked by political instability matched by a dense network of veto points, including the President and the judiciary, that had an impact on the direction of health reforms. As the chapter highlights, some of the main issues have been high out-of-pocket payments, corruption, and privatization and commercialization of public hospitals.

Prepayment schemes

2017 ◽  
Author(s):  
Jan Abel Olsen
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Three Dimensions ◽  
World Health ◽  
Health Coverage ◽  
Public And Private ◽  
Revenue Collection ◽  
Otto Von Bismarck ◽  
Health Organization ◽  
Universal Health

This chapter considers two different ways of organizing revenue collection in statutory healthcare schemes: social health insurance and taxation. The two models are commonly referred to as ‘Bismarck vs Beveridge’ after the men associated with the origin of these systems: the first German chancellor Otto von Bismarck (1815–1898), and the British economist Lord William Beveridge (1879–1963). The differences between these two compulsory prepayment schemes are discussed and compared with private health insurance. Based on a simple diagram introduced by the World Health Organization, three dimensions of coverage are illustrated. Some policy dilemmas are highlighted when attempting to achieve universal health coverage. Finally, various combinations of public and private prepayment schemes are discussed.

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