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Getting Better: Improving Health System Outcomes in Europe and Central Asia
especially those in ministries of finance and health, as well as broader policy circles engaged in health sector issues in these countries and with international agencies. The reality of ECA’s long-term health sector struggles is not new, but as the years go by, its policy urgency only increases. Figure 1.5 provides a road map to help organize the way forward. In the simplest of terms, the health sector is about better health and how to pay for it. That is, it is about improving health in a way that does not impose excessive financial burden on either households (financial protection) or on government budgets (efficiency). Both better health and money for other priorities are important to people: they are both direct contributors to overall welfare. Underlying the road map are the elements of a conceptual framework familiar to economists—a welfare maximization problem. Since improving welfare is the overall objective of policy applied to any sector, the road map begins there and will explore the contribution of both health and income to that goal (chapter 2). We then proceed to focus on the slow pace of convergence in four respects. We start with health and its determinants and discuss what can be done to improve outcomes (chapter 3). Next we look at the other side: how to ensure that the potentially costly and uncertain financial burden that may be associated with ill health does not impose undue suffering on households (chapter 4), which have other spending priorities as well. This is followed by a similar discussion about mitigating the efficiency losses that the health sector may inflict on government budgets (chapter 5). They too have many other spending priorities. Finally, the “health” and “money” issues are unified once again in a broader discussion of the institutional policy agenda FIGURE 1.5
A Road Map to the Report WELFARE Chapter 2: Improving welfare: The value of health
HEALTH Chapter 3: Improving health: The heart of the matter
INCOME and CONSUMPTION Chapter 4: Improving financial protection: A safety net for all Chapter 5: Improving efficiency: Cutting the fat
HEALTH SYSTEM INSTITUTIONAL REFORMS Chapter 6: Improving institutions: Ingredients, not recipes
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