Health-Care Financing Reforms in Central and Eastern Europe: Common Problems and Possible Approaches
26 Pages Posted: 2 Feb 2012
Date Written: April 3, 2008
Mihaljek focuses on health care financing issues in Central and Eastern Europe from the public finance and macroeconomic perspectives, given that there are defective financial incentives to health-care providers and an unsustainable structure of health-care financing. There are several similarities among the countries in question: their health care systems are ineffective, the current manner of financing the sector will become increasingly unsustainable, and reform options need to be examined immediately to prevent the systems’ financial collapse. Whereas most recent health care financing reforms have focused on cost containment, resulting in a shift of a growing portion of health care costs onto households and in uncoordinated efforts among sectors, Mihaljek recommends financing a larger share of health care expenditure out of general tax revenues. Replacement of flat fees with fee-for-service payments based on a points system, accompanied by suitable monitoring and auditing of the bills submitted by primary care providers and a reform of the system of co-payments, would be desirable to keep costs from escalating. Finally, Mihaljek stresses the importance of the authorities’ ability to manage the political economy aspects for the success of health care reform.
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