Czech Republic

After the so-called Velvet Revolution of 1989 released Czechoslovakia from its relationship with the Soviet bloc, the country resumed the liberalizing process that had been put down in 1968 by the Soviet Union. In a “velvet divorce” on New Year's Day 1993, the country divided into the Czech and Slovak republics. The Czech Republic is one of the most financially stable countries in Eastern Europe, and living conditions have been further strengthened by entry into the European Union (EU) since all member states are required to meet EU guidelines. Major pension and healthcare reforms are in the planning stages.

With a per capita income of $20,000, the Czech Republic is the 53rd-richest country in the world. Unemployment stands at 8.9 percent, and unemployed workers often depend on the government for assistance. Budget cuts in 2004 led to the tightening of eligibility for such assistance. There is no abject poverty, but income inequality does exist. The Czech Republic ranks 25.4 on the Gini index of inequality, with the richest 10 percent of the population claiming 22.4 percent of all resources and the poorest 10 percent sharing 4.3 percent. The United Nations Development Programme Human Development Reports rank the Czech Republic 30th in the world on general qual-ity-of-life issues.

Between 1993 and 2004, the government spent an average of 17 percent of the budget on healthcare. Currently, health spending is 7.5 percent of the Gross Domestic Product (GDP), and $1,302 (international [Page 470]dollars) per capita is allotted for health-related programs. Ninety percent of health expenditures derive from government funding; 85.4 percent of that amount is directed toward social security, which is financed by contributions from employers (19.5 percent of payroll) and employees (6.5 percent of earnings) and supplemented by the government. The elderly, the disabled, and survivors are covered under social security. The private sector accounts for only 10 percent of health spending in the Czech Republic, and 83 percent of that involves out-of-pocket expenses. There are 3.51 physicians, 9.71 nurses, 0.47 midwives, 0.66 dentists, and 0.55 pharmacists per 1,000/population in the Czech Republic.

A health crisis erupted in February 2006 when more than 100,000 members of the health profession demanded the immediate resignation of the new health minister who had promised to make the struggling health industry more financially viable. Detractors argued that the reforms were returning the health profession to a state-controlled system. Physicians and pharmacists went on strike, outraged that the minister had used his authority to set limits for insurance coverage that slashed rates for their services. Some Czechs maintained that services were being denied and overall health threatened by the minister's actions. Another potential crisis loomed over whether or not healthcare workers would leave the country en masse to seek more lucrative employment in other EU states. The government was particularly concerned about the ongoing loss of Czech physicians who earn only a fourth of the salaries paid to doctors in other EU countries.

The population of 10,235,455 Czechs enjoys a life expectancy of 76.22 years, with women outliving men an average of six years. Literacy is high at 99 percent, and primary and secondary schooling is available to all students. Safe drinking water and improved sanitation are also universally available. Birth control is used by 72 percent of Czech women, and the Czech Republic has the sixth-lowest fertility rate in the world (1.21 children per female). All births are attended by trained personnel, and 99 percent of women receive antenatal care. The adjusted maternal mortality rate is one of the lowest in the world at nine deaths per 100,000 live births.

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