Abstract :
Policy makers in the so-called transition countries,1 as in all countries, face the
challenge of improving the performance of their health systems. These countries
share a unique historical experience – the period and collapse of communist
rule – and all embarked on an unprecedented social, political and economic
transition that began at the end of the 1980s. Despite this shared history, differences
emerged (or became more apparent) in the early years of transition. Most
obviously, there are large economic differences between the countries, with the
richest country, Slovenia, having an estimated purchasing power parity-adjusted
per capita gross national income in 2008 of $26,910 compared with that of $1860
in the poorest, Tajikistan (World Bank, 2009) (Table 1). The transition created
particular challenges and opportunities for their health systems, in general, and for
health financing systems, in particular. And indeed, most of the countries introduced
either comprehensive or piecemeal reforms in a number of areas, including
the introduction of compulsory health insurance (CHI) funds, changes in provider
payment methods and changes in benefit packages and user charges.
