Markova, N: Equity and Health Care in Transition

The collapse of the communist regimes in Central and Eastern Europe heralded the beginning of an economic transition from central planning to market economies. The subsequent period was marked by malfunctioning of these countries‘ social sectors, including their health care systems, raising serious issues of equity. This book examines the impact of the transition period and the introduction of social insurance on equity in health care provision in Bulgaria. Equity in health care is investigated with respect to function - i.e. financing and delivery - and outcomes - i.e. health status, income inequality and poverty. The methodology provides new ways of modelling health care financing and delivery. The book concludes that social insurance does not provide a uniform means of improving equity and that the root cause of the problem lies in the large proportion of out-of-pocket payments and the rather limited size of the health insurance sector. The data suggests that there are differences between socio-economic groups as regards their likelihood to seek treatment for their ill health, which result in differences in their health status.