ABSTRACT
This chapter presents a brief retrospective review of some of the intrinsic constraints influencing resistance to health care system change, anticipated changes to these systems, and actual program outcomes. In the post-Soviet transitional economies, a more progressive medical discourse emerged that tried to explain the legacy of the existing health care system, that is, its structure, function, administration, financing, service distribution, and, especially, its health care outcomes. The chapter examines both unresolved and ongoing health care system issues that should be acknowledged now so that reform policies can be developed to improve current and future health care systems. The following areas were identified by Western donor organizations for future intervention: activities related to financing health care, improving the continuum of care, improving quality of health services, mobilizing citizens and communities for better health, and advancing public health. Corruption in the health care sector impacts macroeconomic growth and international status as it reduces economic development through a loss of international investment.
