Healthcare in Eastern Europe

by Jose Marc Castro on August 8, 2009

healthcareFRANCEHealthcare in the former Soviet Bloc countries is at best, inconsistent and comparatively inadequate unlike those in the Western Europe. Eastern Europe has been trying to reform this situation in a number of ways, but are government efforts succeeding?

Overview of Healthcare in Eastern Europe

Eastern Europe, in recent years, has become a popular destination for British expats looking to retire offshore or to purchase a second home. Unfortunately, Eastern Europe’s healthcare system leaves much to be desired as making retirement in these Soviet states a questionable proposition. Developing countries like The Czech Republic or Bulgaria shows a big gap between these poorer territories and Western Europe: the average GDP per head in Eastern Europe is around $8,300 compared to $45,000 in the UK.

No doubt, this situation reflects in the local healthcare system. In the former Yugoslavia, people are riddled with respiratory and digestive tract diseases. The occurrence of tuberculosis in Romania rates higher than Africa. Patients in the countryside must travel hundreds of miles before reaching the nearest hospital in the next city. Medical degrees are being sold in the black market while hospital management preventive medicine and ambulatory care are sorely insufficient.

Local healthcare authorities have bewailed the current state of government-provided health services. In an article published on March 2000 in “Central Europe Review” entitled “Trying our Patients”, Professor Pavel Pafko, Head of the Third Surgery Department in Charles University Faculty Hospital, Prague, says “In the public’s mind the idea of ‘free health care’ survived …as does the idea that all of us are equal as long as we are healthy. The sick man …loses this equality and cannot himself pay by legal means for what the state, or …insurance companies, have no resources to provide.”

Access to the Healthcare System in Eastern Europe

All Eastern European countries are required to participate in the public health insurance system, though the overall standard of provision in the public sector is quite poor. The main beneficiaries are those in the lowest income brackets. Private clinics are reserved for the wealthy – for example in Budapest, one clinic caters to mostly expatriates – making such services expensive. Giving the doctor a ‘reward’ or a ‘success fee’ is common practice if you are seeking competent specialist treatment for chronic ailments, major surgery, or childbirth.

Private medical insurance is generally good, though not useful when you move out of the country. There is also a question mark hanging over their financial security if they suffer a bad run on claims. International health insurance providers give expats coverage amounting to 1 million dollars, but not all policies are portable when you return to your original country of residence.

Challenges With Healthcare in Eastern Europe

As many good doctors in Eastern Europe are flocking over to the west to seek greener pastures, the pressure for better healthcare continues to rise, resulting to private medical insurance doubling in growth in the region. The shortage of competent doctors and health care workers are taking its toll on the general health of the public, which continue to complain of over crowded hospitals and clinics.  These are also inadequately equipped due to under funding.

Nevertheless, healthcare in the private sector has its own challenges as well. The number of private clinics are lacking while the treatment options are limited. Private medical policies only cover dental care, long-term hospital stays, plastic surgery and serious illnesses as standard public health insurance covers all basic outpatient and inpatient services, which at bottom, remain unsatisfactory.

As healthcare workers continue to suffer from unpaid salaries for months, ‘under the table’ fees become more rampant. The general landscape is characterized by a chronic shortage of medicines and other substances while hospital equipment are in a general state of disrepair.

On the Brighter Side of Healthcare in Eastern Europe

Not all Eastern European governments are struggling in a state of hopelessness and compromise. In Romania, for example, at least half the population is satisfied with healthcare services. The country’s 1997 Health Insurance Law has made provisions for Romanian citizens to pay a third of their health bills in order to supply what the government does not have the resources to subsidize. Romania’s health insurance houses pay health care providers such as hospitals based on capitalization or a projected global budget. They are now experimenting with methods involving fee-for-service reimbursement.

Private dental and medical clinics, laboratories, and polyclinics now work with private pharmacies and apothecaries while the government pays general practitioners or ‘family doctors’ on a contractual basis per socially-insured patient treated. These GPs use rent-free clinics and equipment, and they have begun to borrow capital from banks to open their own practice.

The Bottomline With Healthcare in Eastern Europe

The problem with healthcare in Eastern Europe is that practice and theory remain far behind from Western European counterparts. Still reeling from a continuous downward spiral of unhealthy living conditions and governments without enough resources to cover the need, the region will suffer all the more while dragging those who are in dire need of adequate and sufficient healthcare down with them. In the current climate, some form of international health cover is essential in Eastern Europe particularly for families and older expatriates. If you are planning to move to the region, you have to check whether your policy is portable and if it will cover you when you return to your home country.healthcareFRANCE

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