Welfare, Choice and Solidarity in Transition

Although the book confines itself to discussing health-care reform, the principles expounded in this chapter have a validity that extends beyond the health sector. Those who accept these principles may apply them to reforming other sectors of the welfare state inherited from the socialist system, such as the pension system, the public assistance and unemployment benefits system, or the financing of education. The comments have been phrased to apply to the welfare sector as a whole.

Some of the principles expounded in this chapter are universal in character, in our view, and therefore not restricted to any country, region, or set of initial conditions. Others have been suggested by the present state of the welfare sector in the post-socialist countries. We have tried to formulate principles that are valid for every post-socialist country and to that extent the chapter points beyond conditions specific to Eastern Europe (as defined in the introduction).

Altogether nine principles are advanced. The first section presents those ones related to fundamental values. The next section concerns the desirable attributes of the reformed welfare sector's institutions. The final section considers the allocation proportions appropriate to the welfare sector.

It would have been better to have conducted a far more rigorous, axiomatic discussion that started from postulates and auxiliary postulates and the conclusions to be drawn from them. It would then have appeared that the principles are not just listed one after another, but bear logical relations to each other, forming a closed theoretical structure.