The Public Healthcare System in the Transition Countries the Case Study of Serbia

Abstract

The public healthcare system of Serbia, from the beginning of the past century, when more or less the unperceivable demolition of socialism, was faced with great problems. During the time, they became almost unsolvable due to servitude to old ideas and approaches to goals, organization and managing the state and public sector, political work and everday public and business managing. The application of ruling ideology, performed during the nineties of the last century and the restoration of capitalism expressed itself as unproductive, because everything else remained the same – methods of work, approach, values and standpoint. Its basic feature is institutional non-regulation being the consequence of unclear, foggy and manipulated transition. There are multiple reflexion to the public healtcare system. First the space for the wild privatisation of one part of the public healthcare system was open as well as for the development of irregular partnership between the public and private sector in the production of public goods and services. Second, the creation of a complex, to distribution oriented coalition was initiated that, within the framework of historical heritage, very skillfully using its political and any other influence intended to retain such a situation and stop necessary structural changes in the public healthcare system and the regular development of the private sector as well. Third, within of the framework of foggy and damped transition, arose the miracuous mixture of quasipublic, quasi-market and administrative mechanisms of regulation that nonsensenses necessity for the existence of the public healthcare system. Conseqently, Serbia needs the total reingeneering as a radical, qualitative and on inovations based methodology which, on the basis of development vision, should determine the direction of institutional changes and various reformatory operations in order to construct a radically new public healthcare system – oriented to prevention and preservation of health capacity (of the whole national population) on the basis of development of the relevant system of life and work while the medical treatmant of the mayor part of maladies, especially of those needing sofisticated and costly technologies, should be awarded to the private sector on the basis of personal participation. The key of implementation is in the new definition of the contents of paradigm “equity”. Paradigm that the public health insurance should provide the best healthcare for everybody is false and financially untenable even for much more wealtheir societies. On the other side, equity means necessity to provide the health care in the framework of public, transparent and precise minimum standards for everbody (meaning that nobody will die because he is not insured, because he has not money for cure or, simply, as often happens in Serbia, because he do not know relevant people).Public healthcare system, Unclear, foggy and manipulated transition, Institutional non-regulated environment, Total reingeenering, “Equity”