Poland

The Republic of Poland is one of the most successful of the transition economies. In the 1990s, as Poland began its transformation into a market economy, a so-called “shock therapy” program reformed the entire system. With a per capita income of $13,000, Poland now ranks as the 73rd richest nation in the world. Unemployment has, however, continued to rise, increasing from 6.3 percent to 16.4 percent between 1990 and 1993. At present, Poland's unemployment rate (18.2 percent) is the highest among members of the European Union (EU). Inflation initially soared during the early transition from a social to a market economy, climbing to 71 percent in 1991. Within three years, the inflation rate had dropped to 10 percent. In 2005, it had declined still further (2.2 percent). Poland continues to be adversely affected by a dilapidated infrastructure. Although the Polish economy is diversified, 16.1 percent of the labor force is engaged in the agricultural sector.

The fall of socialism in Poland increased income disparities. By 1999, 14.4 percent of the population was living below the poverty line; today, that number has increased to 17 percent. Most of those who live in abject poverty are concentrated in rural areas. Poland ranks 34.1 on the Gini Index of Inequality. The richest 10 percent of Poles claim 26.7 percent of the country's income, leaving 3.1 percent for the poorest 10 percent. Nevertheless, the standard of living is among the highest in the former socialist republics, and the United Nations Development Programme (UNDP) Human Development Reports rank Poland 37 of 177 countries on overall quality-of-life issues.

[Page 1392]The history of health insurance in Poland can be traced to the period between the two world wars when a limited insurance plan was instituted, covering only 7 percent of the population. In the post–World War II era, healthcare became a public responsibility, and the central government assumed responsibility for the healthcare system. Unlike most Soviet republics, Poland refused to abolish private practice for physicians. In the 1950s, further healthcare reforms led the government to provide coverage for state employees, and occupational health clinics became a standard fixture of the workplace. In the 1980s, the government began decentralizing the healthcare system, transferring responsibility to local governments (viuvidsguos). In 1997, the Universal Health Insurance Act was enacted to provide for mandatory universal medical coverage, with the state guaranteeing insurance security. At that time, healthcare taxes were phased out, and 17 “sickness funds” were established to finance health-care. The National Health Program of 1996–2005 established 18 target goals, which included promoting healthier lifestyles and preventive health and improving the quality of health services.

Because of the decentralization of healthcare services, only 2 percent of the government's total budget is allocated to health. The government spends 6.5 percent of the Gross Domestic Product (GDP) on health-care, allotting $745 (international dollars) per capita. Health spending accounts for 69.9 percent of all health expenditures, and 86 percent of this amount is directed toward providing social security. The private sector accounts for 30.1 percent of health expenditures. Around 88 percent of all private expenses are generated from out-of-pocket expenses. There are 2.47 physicians, 4.90 nurses, 0.57 midwives, 0.30 dentists, and 0.77 pharmacists per 1,000 population in Poland.

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