The Political Economy of Slovak and Czech Health Policy: 1989-2000

Abstract

After 1989, the Czech and Slovak health-care systems followed dissimilar policies. Change was faster, more profound and more experimental in the Czech Republic. But after 10 years there are clear similarities in their health status achievements and systemic problems. By showing how a common past and a similar insurance-based finance model interact with commitments to universal access, the common outcomes and problems are explained. It is argued that greater spending, rather than privatization, has improved health-care outcomes since transition began. It is also argued that most of the key problems with the two systems are finance related.

Social Health Insurance and Its Failures in the Czech Republic and Slovakia: The Role of the State

“…The change to a health insurance system was supported by typical arguments about plurality, independence and competition (see Lawson, Nemec, 2003), as the main positive features of new insurance-based system. For post-communist countries the political economy rationale for such switch from a tax-based to an insurance-based financial model is a mixture of economic, administrative and political considerations.…”

Anthropometric Dividends of Czechoslovakia's Break Up

“…The Czechoslovakian case allows us to identify the trajectories before and after the break up. Just like the literature on secession, the evidence on the democratic transition and its effects is even more extensive, covering all areas from economic welfare to institutional changes (Hausner, Jessop, & Nielsen, 1995;Inglot, 2008Inglot, , 2009Kostecki, Zukrowska, & Goralczyk, 2000;Milanovic, 1998;Whitefield, 1993;Winiecki & Kondratowicz, 1993) to health effects (Bobak & Feachem, 1992;Cornia & Paniccià, 2000;Ginter, Simko, & Wsolova, 2009;Lawson & Nemec, 2003;Stillman, 2006). Broadly speaking, the evidence points to the difficult transition years with Czech Republic having performed better than Slovakia on a range of aspects.…”

Health Policies versus Health Care Reforms and their Success in Central and Eastern Europe

“…The Czech and Slovak reforms, establishing "competitive" health insurance system in 1993, when their financial markets did not work, is typical example of such advice, with obvious and well described outcomes (Lawson and Nemec, 2003).…”