Russia and Commonwealth of Independent States
People in transition: reforming education and health care
How transition countries need to change their education and health care systems
Authors:
N. Barr
Publisher:
World Bank, 1996
This article, published by the World Bank, examines the education and health care systems of Central and Eastern Europe (CEE), the former Soviet Union and China, the problems that have arisen during the transition to a market-based economy in these countries, and argues that reforms are needed. It notes that whilst infant mortality rates have dropped and life expectancy has increased in some of the CEE countries, mortality rates worsened in the former Soviet Union, especially in Russia. China’s health performance appears to have worsened since the 1980s as a result of changes to rural health policy which reduced access to collective health insurance.
Considering reforms in health care, the author recommends policies to educate the public about life-style choices such as smoking and alcohol abuse; and reforming the quantity, mix and quality of health services. Countries should give greater priority to maintaining the strong record of preventive care achieved under the pre-transition systems. Relying mainly on public, rather than private, funding helps to contain costs and ensure access. Health services can be delivered effectively by both public and private providers, or by a combination of both. Attention is also needed to the political economy of reform processes, given the power held by the medical lobby in many transition countries.
