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Welfare, Choice and Solidarity in Transition
Reforming the Health Sector in Eastern Europe

$29.00 USD

Part of Federico Caffè Lectures

  • Date Published: January 2005
  • availability: This ISBN is for an eBook version which is distributed on our behalf by a third party.
  • format: Adobe eBook Reader
  • isbn: 9780511031335

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About the Authors
  • Reform of the welfare sector is an important yet difficult challenge for all countries in transition from socialist central planning to market-oriented democracies. Here a scholar of the economics of socialism and post-socialist transition and a health economist take on this challenge. This 2001 book offers health sector reform recommendations for ten countries of Eastern Europe, drawn consistently from a set of explicit guiding principles. After discussing sector-specific characteristics, lessons of international experience, and the main set of initial conditions, the authors advocate reforms based on organized public financing for basic care, private financing for supplementary care, pluralistic delivery of services, and managed competition. Policymakers need to achieve a balance, both assuring social solidarity through universal access to basic health services and expanding individual choice and responsibility through voluntary supplemental insurance. The authors also consider the problems that undermine effectiveness of market-based competition in the health sector.

    • Analysis and recommendations for reform of health care financing and provision are based on the distinctive initial conditions of Eastern Europe
    • Written to be accessible to policymakers and non-specialists
    • All recommendations flowing directly from nine guiding principles articulated at the beginning of the book
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    Reviews & endorsements

    Review of the hardback: 'To judge from its title, Janos Kornai and Karen Eggleston have written a book about health care reform in Eastern Europe. In fact, they have done much more. Following their own axiom of transparency, they begin by setting out goals of health care and other social support systems in a fresh way, and go on to apply the goals to the practical tasks of health care financing and organization. In so doing, they make a large contribution to a small literature, a comparative analytical treatment of many countries' health care systems together with advice for the would-be reformer.' Joseph P. Newhouse, Harvard University

    Review of the hardback: 'A book bringing together a lifelong student of socialism and a highly-trained health economist was likely to produce either a major disconnect or to provide intellectual fireworks through novel ways of dissecting the issues and provocative insights into old problems. Lovers of fireworks should read on.' Nicholas Barr, London School of Economics and Political Science

    Review of the hardback: '[It] gives the reader a number of provocative insights into the health care challenges of the coming decade in Eastern Europe.' Health Affairs

    Review of the hardback: 'The authors' intrinsic knowledge of the political economy of transition countries, their profound understanding of the historic context of the region, and their comprehensive approach to this rather complex topic make the work especially valuable for decision-makers and opinion leaders in Europe. In this context, the book fills a considerable void.' Health Affairs

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    Product details

    • Date Published: January 2005
    • format: Adobe eBook Reader
    • isbn: 9780511031335
    • availability: This ISBN is for an eBook version which is distributed on our behalf by a third party.
  • Table of Contents

    Part I. Points of Departure:
    1. The general principles of reform
    2. The characteristics of the health sector
    3. Some international experiences
    4. The health sector in Eastern Europe: the initial state
    Part II. Guidelines for Reform:
    5. The demand side: financing, benefits, and organization of insurance
    6. The supply side: delivery system ownership, organization, and contracting
    7. The interaction of supply and demand: pricing, payment, hard budget constraints, and overall health-sector development
    8. Concluding remarks.

  • Authors

    János Kornai, Harvard University, Massachusetts

    Karen Eggleston, Tufts University, Massachusetts

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