ABSTRACT
The role of the communist party-state in the health care system Like its Soviet counterpart, the Czechoslovak socialist health service system was a state-operated, tax-financed, specialized branch of the general public service. The communist party-state exercised tight budgetary control over medical facilities, technologies, drugs and salaries, and a high degree of administrative power over health norms and standards. With few exceptions (for instance, the health care services for the party nomenklatura, the army and railway workers), the entire health service was centralized under the Czech and Slovak Ministries of Health.2 At the top of the organizational pyramid was the socalled ‘chief specialist’ (a physician by training), who was a full-time administrative official of the national Ministry of Health with responsibility for medical standards. The chief specialist gave direction to the officially designated regional and district specialists. Party membership was a requirement for these positions of authority in the administration of health services, though this was usually not necessary for the more clinical work of chiefs of hospital departments and ambulatory clinics.
