• Social protection in transition economies

Social protection in transition economies

This article, published by the European Observatory on Health Systems and Policies as chapter 3 of the book "Health Services in Transition: Learning from Experience," examines efforts to strengthen health care financing in the transitional economies of eastern Europe and the former Soviet Union. It reports that social health insurance, which has been central to financing reform in many countries, appears to have been successful in higher-income countries with higher levels of formal employment, but not in lower-income countries such as Albania, Kazakhstan and Romania. General government revenues continue to play a significant funding role. Major challenges include the weak macroeconomic context, corruption, the low level of autonomy given to providers, and the absence of routine information systems.

The article argues that, while economic recovery and capacity building will go some way towards increasing the revenue collected through taxes, further efforts to improve compliance with social health insurance will be needed, including dealing with corruption. Defining a more realistic benefits package will also be a key strategy in making the system financially sustainable and targeting public revenues at the poorest segments of the population. The article recommends that, for financial reforms to succeed, they need to be accompanied by reforms in the provision of care.

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