The Role of Ideas In Welfare Reforms in Central-Eastern Europe

WP-LPF 4/18

In the 2000s, in two Central Eastern European (CEE) countries - Slovakia and Hungary - governments proposed plans for welfare reforms that entailed radical shift from a state- to a market-oriented healthcare system. This paper focuses on the following question: Why did the governments in the two countries propose these reforms when support for the state-run healthcare in these two post-communist countries is still high? The paper shows that the healthcare policy reforms of the two Central Eastern European countries cannot be explained by the dominant accounts of policy change that assign key role to the characteristics of the government, such as its political orientation. Instead, the paper argues that the emergence of market-oriented reforms in the two countries is best explained by neoliberal ideas that strongly influenced government healthcare agenda. The neoliberal ideas built upon belief in the superiority of the market over the state and strongly influenced the CEE governments’ plans for healthcare reforms offering solutions for two core policy problems - the healthcare sector-specific deficits and the increased pressures for budgetary control in the context of Europeanization.