Development of Scenarios for Health Expenditure in the New EU Member States: Bulgaria, Estonia, Hungary, Poland and Slovakia

The report is a result of the Ageing, Health Status and Determinants of Health Expenditure (AHEAD) project within the EC 6th Framework programme. The objective of the research was to present the model of future health care system revenues and expenditures in selected Central and Eastern European countries (CEE) which are now the New EU Member States, and to discuss projection assumptions and results. Selected countries include Bulgaria, Estonia, Hungary, Poland and Slovakia. The projections are based on methodology adopted in the International Labour Organization (ILO) Social Budget model. The projection examines impact of demographic changes and changes in health status on future (up to 2050) health expenditures. Next to it, future changes in the labour market participation and their imact on the health care system revenues are examined. Results indicate that due to demographic pressures health expenditures will increase in the next 40 years and health care systems in the NMS will face deficit. Moreover, health revenues, expenditures and deficit/surplus are slightly sensitive to possible labour market changes. Health care system reforms are required in order to balance the disequilibrium of revenues and expenditures caused by external factors (demographic and economic), and decrease the premium needed to cover expenditures. Such reforms should lead, on the one hand, to the rationing of medical services covered by public resources, and on the other, to more effective governance and management of the sector and within the sector.