Mare Ainsaar, Ave Roots, Jüri Kõre
Jul 2, 2021
Health Politics in Europe
This chapter provides an extended look at health politics and the social health insurance system in Estonia. The chapter traces the historical development of the Estonian healthcare system through a series of regime changes, all of which affected healthcare. The post-1991 transformation of Estonia’s health system went rapidly and was marked by relatively high consensus and professionalism. Consequently, stable financing and a large tax component allowed Estonia’s national health fund to avoid the heavy dependence on out-of-pocket payments characteristic of many other transition countries. Despite plans for decentralized social insurance, by 2000 the decision was made to centralize the social insurance system, which has become essentially a single-payer system. This has allowed quite a bit of leverage for setting healthcare priorities. But, as the chapter argues, given the pressure for austerity after the 2008 financial crisis, reduced capacity has led to longer waiting times.