Health Reforms in Central and Eastern Europe

Options, Obstacles and Limited Outcomes

James Warner Björkman;Juraj Nemec (redactie) 9789462360631 | 1e druk, 2013


Given dramatic changes in Central and Eastern Europe since the fall of Berlin Wall 1989 and the dissolution of  the Soviet Union in 1991, local area experts were challenged to examine their national systems of health care as well as proposals to reform them. Each chapter provides contextual data and information on the empirical realities of a specific country at five-year intervals since 1990 as well as the organizational framework of its health care system. The book explores the historical thread of reforms attempted and their current state of implementation by addressing criteria for reforming national health systems such as costs, effectiveness, efficiency, equity and feasibility. The authors stress selected policy elements such as the roles of major actors, the shadow economy, cost containment, access, centralization and decentralization.  While no blueprint is offered, intriguing patterns emerge across the cases plus observations about ‘next steps’ in the unfolding process of health reforms in the region.


Policy makers, professional practitioners, students. Disciplines: health administration; public management; political science and area studies (Europe, CIS).


James Warner Björkman is Professor Emeritus of Public Policy and Administration at the Institute of Social Studies, The Hague, The Netherlands, and past Chair of the International Political Science Association’s Research Committee on Comparative Health Policy

Juraj Nemec is Professor of Public Finance and Public Management at Matej Bel University in Banska Bystrica (Slovakia) and at Masaryk University in Brno (Czech Republic).                      


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