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.

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.

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.

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.

The Czech Republic

2021 ◽  
pp. 683-722
Author(s):  
Tamara Popic
Keyword(s):  
Czech Republic ◽  
Healthcare System ◽  
Social Health Insurance ◽  
Controversial Issues ◽  
Healthcare Provision ◽  
The Czech Republic ◽  
Health Politics ◽  
Insurance System ◽  
Political Divide ◽  
Universal Health

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.

Bulgaria

2021 ◽  
pp. 816-856
Author(s):  
Guergana Stolarov-Demuth
Keyword(s):  
Health Insurance ◽  
Healthcare System ◽  
Free Market ◽  
Social Health Insurance ◽  
Social Health ◽  
Reform Process ◽  
Control Mechanisms ◽  
Public And Private ◽  
Health Politics ◽  
Insurance System

This chapter provides an extended look at health politics and the compulsory health insurance system in Bulgaria. It traces the historical development of the Bulgarian healthcare system characterized by the introduction of social health insurance, which after the establishment of communist rule in Bulgaria after World War II was replaced with a state-run healthcare system. Starting in 1989, Bulgaria underwent a transition to democracy and free market economy. This triggered structural healthcare reforms, including the re-introduction of social health insurance with both public and private provision. However, as privatization was permitted without effective price control mechanisms and conditions for entry into the public insurance system, out-of-pocket payments became extensive, especially for pharmaceuticals. The main reform challenges have been to close the coverage gaps and secure sufficient financing by stipulating selective contracting with hospitals, strengthening the control on pharmaceuticals, and tightening the collection of insurance contributions. While political debates were initially structured along traditional left–right political party lines, since 2001 new center-right parties have shaped Bulgarian health politics. Nevertheless, the reform process still suffered from lack of continuity, and private interest groups have successfully blocked cost-containment policies.

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.

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.

scholarly journals Moving Towards Universal Health Coverage

2018 ◽  
pp. 19-45
Author(s):  
Ching Yuen Luk
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Coverage ◽  
Health Insurance System ◽  
Insurance System ◽  
Social Health Insurance System ◽  
The Government ◽  
Universal Health

This study uses a refined version of historical institutionalism to critically examine the complex interplay of forces that shape the health insurance reform trajectory in China since the mid-1980s and identifies problems that impede the government from achieving universal health coverage (UHC). It shows that China's multi-layered social health insurance system has covered more than 95 percent of its population, but failed to provide insured people with access to a range of essential services and make health care affordable. To achieve UHC, the government has to overcome significant hurdles, which include the inherently discriminatory design of the social health insurance system, disorder in the drug distribution system, deficits in the funding of health insurance, and insufficient medical protection for the old people.

scholarly journals Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

2021 ◽  
Vol 6 (2) ◽  
pp. e004117
Author(s):  
Aniqa Islam Marshall ◽  
Kanang Kantamaturapoj ◽  
Kamonwan Kiewnin ◽  
Somtanuek Chotchoungchatchai ◽  
Walaiporn Patcharanarumol ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Civil Servant ◽  
Social Health ◽  
Health Coverage ◽  
Medical Benefit ◽  
The Social ◽  
Universal Health ◽  
Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

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