The politics of healthcare reform in postcommunist Europe: The importance of access

Why do countries move from public to private financing of healthcare? This paper explores this issue by looking at the divergent reform trajectories of three postcommunist countries the Czech Republic, Hungary, and Poland. While existing accounts emphasize veto points to explain changes in healthcare systems, the present analysis finds that moves towards private financing can be better explained by differences in access to the policymaking arm of the state. Specifically, a penetrable single-party government and weak bureaucratic capacities allow physicians to capture the reform process and implement their preferred policies. The results suggest that scholars of health policy should focus more attention on the actors seeking change and their access to policy makers.