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Kurzfassung auf Englisch:

Health care reforms carried out in Poland since 1990 have led to the decentralization of ownership and financial and management responsibility of health care establishments; privatization of health care providers; stronger reliance on private expenditure on health care with rising out-of-pocket and informal payments; exclusion of some services from the package of universal health services; and restricted access to some health services in form of waiting lists. Even though the official aim of the reforms was to preserve a stateguaranteed egalitarian health care system while ensuring optimal use of resources by the introduction of market-type mechanisms, smaller than expected gains in efficiency, together with demographic and technological pressure on health care costs and a political and economic climate unable to significantly increase public spending, resulted in a more privatized and unequal system than intended. Hence, the reforms of the health system as part of the general transformation of the economy and the welfare state illustrate a shift towards a hybrid “post-communist European type” of welfare state which has inherited some features of the socialist regime, but is increasingly shaped by liberal ideas.

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