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Back to Bismarck: Eastern European Health Care Systems in Transition

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The aim of this book is to describe the current state of health system change in a number of countries of Eastern and Central Europe: the former German Democratic Republic, the Czech and Slovak Republics, Poland and Hungary. Of necessity this description is a cross-section of an ongoing process. We will put the desription in a broader framework by looking back at the history of the systems and by looking forward at current policy plans. To give an updated picture of the latter, we have also used policy documents in the national languages. The country descriptions are up-to-date till June 1996.

The book consists of two parts. The first part contains the general description and analysis of the transformation of the health care systems of the countries studied. This is based on the more detailed description of the developments in the individual countries in the second part of the book. To appraise what has been achieved until now in these countries, it is not enough to describe just the current structure of the health care sector. It is also necessary to desribe the structure as it was right before the cessation of the communist system. And to be able to understand the direction developments are taking, it is also important to have some basic understanding of the past system, before the introduction of communist rule, that these countries can fall back on. Together, these elements form the building blocks of the country descriptions of the health care system; they consist of:

1 a brief statistical portrait of the country,

2 a description of the pre-communist health care system,

4 the stuation shortly before the transformation of the communist systems in 1989.

4 the changes in the structure of the health care systems after 1989.
--- excerpt from book's Preface