Welfare, Choice and Solidarity in Transition: Reforming the Health Sector in Eastern Europe

Description

Reform of the welfare sector is an important yet difficult challenge for all countries in transition from socialist central planning to market-oriented democracies. Here a scholar of the economics of socialism and post-socialist transition and a health economist take on this challenge. This book offers health sector reform recommendations for ten countries of Eastern Europe, drawn consistently from a set of explicit guiding principles. After discussing sector-specific characteristics, lessons of international experience, and the main set of initial conditions, the authors advocate reforms based on organized public financing for basic care, private financing for supplementary care, pluralistic delivery of services, and managed competition. Policymakers need to achieve a balance, both assuring social solidarity through universal access to basic health services and expanding individual choice and responsibility through voluntary supplemental insurance. The authors also consider the problems that undermine effectiveness of market-based competition in the health sector.

'To judge from its title, Janos Kornai and Karen Eggleston have written a book about health care reform in Eastern Europe. In fact, they have done much more. Following their own axiom of transparency, they begin by setting out goals of health care and other social support systems in a fresh way, and go on to apply the goals to the practical tasks of health care financing and organization. In so doing, they make a large contribution to a small literature, a comparative analytical treatment of many countries' health care systems together with advice for the would-be reformer.' Joseph P. Newhouse, John D. MacArthur Professor of Health Policy and Management, Harvard University 'A book bringing together a lifelong student of socialism and a highly-trained health economist was likely to produce either a major disconnect or to provide intellectual fireworks through novel ways of dissecting the issues and provocative insights into old problems. Lovers of fireworks should read on.' Nicholas Barr, Reader in Economics, London School of Economics and Political Science '[It] gives the reader a number of provocative insights into the health care challenges of the coming decade in Eastern Europe.' Health Affairs 'The authors' intrinsic knowledge of the political economy of transition countries, their profound understanding of the historic context of the region, and their comprehensive approach to this rather complex topic make the work especially valuable for decision-makers and opinion leaders in Europe. In this context, the book fills a considerable void.' Health Affairs