Health care systems' evolvement and the changing role of the state in selected CEEC

Despite common heritage, Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, and Slovakia (hereinafter Central and Eastern European Countries - CEEC) opted for different models while reforming their health care systems. A common (and important) component of these reforms was privatization and introduction of various market mechanisms in health care systems. The objective of the paper is to identify main challenges resulting from the health care reforms in CEEC. Review of the literature (using EBSCO and ScienceDirect databases) on the results of the health care reforms in CEEC will be followed by an analysis of the changes in health care financing in CEEC between 1995-2012 with a special emphasis on the role of the state in this process. WHO statistics (data) on national health care expenditures divided further into: total health expenditure, general government expenditure, private expenditure, and out of pocket expenditure (with various configurations) will be used. It is argued that health care reforms led (among others) to shifting the financial risk to patients and the state is slowly (and continually) withdrawing from financing health care in CEEC. This diminishing share of state financing of health care is not compensated by tax deductions and/or other forms of allowances. Also the issue of restricted access to health care is indicated here as a by-product of the health care reforms undertaken in CEEC.