The prospects for public private healthcare in Eastern Europe
publication date: Oct 20, 2010
Whether reform happens or not, private healthcare is set to grow steeply in Eastern Europe.
If reform is pushed through successfully by countries like Romania and Bulgaria, then the private sector will be incorporated far more widely into the solution through PPP and the takeover of state run hospitals. If politicians fail to reform corrupt, ineffective and underfinanced public healthcare services then we will see the continuous and rapid growth of private services as consumers turn to private operators.
Some sort of move to complementary private insurance looks likely in Bulgaria and Romania.
The key question is whether governments are brave enough to create a space where private operators can play a recognised and legitimate role and where the private sector can feel confident enough to really invest hundreds of millions of euros in new facilities. Sadly, we doubt that this will be the case.
The prevailing mentality among politicians seems to remain that they can not afford to be seen to be actively pushing privatisation or massive private involvement. That is the case with the new Hungarian healthcare minister, Miklós Szócska. Anna-Maria Borissova, the Bulgarian minister who was pushing radical reforms has been sacked and the minority Romanian coalition, whilst pushing big changes, won't want to use the "p" word if it can possibly avoid doing so.
So we are likely to see another five years of fudge in which it is left to municipalities to privatise individual hospitals and in which public sector hospitals outsource more and more functions to the private sector. But this piecemeal privatisation is unlikely to deliver the massive new investment that these healthcare systems badly need as the private sector will know that payments can be hugely delayed and that decisions can be rescinded.
