Estonia

Since the dissolution of the Soviet bloc, Estonia has maintained strong ties with the West. The economy is largely dependent on the electronics and telecommunications sectors and on trading relations with Finland, Sweden, and Germany. With a per capita income of $17,500, Estonia ranks 58th in world incomes. The Gini coefficient for Estonia is 37.2. The richest 10 percent hold 29.8 percent of the country's wealth while the poorest 10 percent share only three percent. Unemployment stands at 7.9 percent and inflation at 4.1. Although Estonia has a low external debt, the budget deficit draws needed resources away from social programs. The United Nations Development Programme's (UNDP) Human Development Report ranks Estonia 40th among 177 countries on overall quality of life issues.

During the transition to a market economy, the government attempted to turn Estonia into a social welfare state, implementing the Estonian Healthcare Project (1995–98) according to World Health Organization guidelines to improve the quality of health-care. In 2001, the Health Services Act set quality controls on healthcare and established the Healthcare Board. A social tax designed to generate funding for health services, pensions, and child benefits was also implemented. Despite good intentions, the government could not absorb the costs of the program, so benefits were reduced. Local governments were assigned the responsibility for administering social assistance, and living and housing allowances were abolished. The elderly were disproportionately affected by the changes.

Between 1993 and 2004, Estonia spent an average of 16 percent of the budget on healthcare. The government now commits 5.3 percent of the Gross Domestic Product (GDP) to healthcare, allotting $682 (international dollars) per capita. Government funding provides 77.1 percent of total health expenditures, and 84.9 percent of that amount is earmarked for social security. In Estonia, social security is a combination of social insurance and mandatory individual accounts. Employees do not pay for the program, but the self-employed pay one-third of the minimum salary, and employers are required to contribute one-third of payrolls. The program covers the elderly, the disabled, and survivors.

The private sector furnishes 22.9 percent of health-care costs, and 88.30 percent of private provisions are derived from out-of-pocket expenses. When out-of-pocket expenses are high, the poorest segment of the population may be unable to afford healthcare or may be impoverished by meeting healthcare costs. Household budget surveys have indicated that the number of households spending more than one-fifth of their capacity to pay for healthcare rose steadily between 1995 and 2002. Again, the elderly who are require constant care and large amounts of medication are disproportionately affected. There are 4.48 physicians, 8.50 nurses, 0.34 midwives, 1.28 dentists, and 0.42 pharmacists per 1,000 population in Estonia.

Estonia's population of 1,324,333 has a life expectancy of 72.04 years. The gap between male (66.58 years and female (77.83 years) is wider than in most countries. Literacy is virtually universal at 99.8 percent. While 99 percent of children attend primary school, enrollment drops slightly at the secondary level. Seventy percent of Estonian women use birth control, giving birth to an average of 1.4 children each. All births are attended by trained personnel. However, Estonia's adjusted maternal mortality rate of 63 deaths per 100,000 live births is relatively high.

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