The Southern Eastern Europe regional outlook presents a comparative assessment of the historical development of the healthcare system, health politics, and selected health-related indicators for Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Kosovo, Montenegro, North Macedonia, Romania, and Serbia. Despite variations in their healthcare systems during communism, since 1989 the countries of the region have all undertaken efforts to introduce or consolidate social health insurance and combine it with a mix of public and private provision. In most of the countries at least half of healthcare financing originates from compulsory contributory health insurance, but in many of them, out-of-pocket payments constitute an extremely large share. Given this financial burden, satisfaction in the region is very low. Health outcomes are unsatisfactory, with low average life expectancy, very high infant mortality, and relatively high levels of health inequality. Unmet need is high, especially in Romania, mainly due to costs. Since at least 2004, healthcare has tended to be a moderately salient issue in Southern Eastern Europe. The key healthcare issues in the region have been incomplete or ineffective social health insurance coverage, privatization, insufficient financing, and high out-of-pocket payments, especially for pharmaceuticals and private services.
Europe And Central Asia's Great Post-Communist Social Health Insurance Experiment : Impacts On Health Sector And Labor Market Outcomes