I18 - Health: Government Policy; Regulation; Public HealthReturn

Slovak Republic as well as many other OECD countries has faced significant increase of health expenditures in last decades. Sustainability of health care public component is therefore and mainly on the ground of ageing of population a political and scientific challenge for many countries. Paper pursues ex ante sustainability of health care system in Slovak Republic. By using modified models of International Labour Organization and European Commission and exogenous macroeconomic and population expectations we forecasts revenues, expenditures and also sustainability of the health care policy scenarios until year 2030. We identified possible changes in the income and expenditures policies for the Slovak health system, which can lead to improve balance of whole system by assumed population and macroeconomic scenarios.

The paper aims at the correspondence of the health care financing systems to the social models (welfare regimes) as defined in the social theory and policy, including the trends in the OECD and CEE countries and utilizing the lessons from typical countries. We compare the liberal, social-democratic, conservative and neo-liberal models of health care financing, mentioning the Communist model and the single-payer system as well. The National Health Service model may also today be considered as a viable, social-democratic model of the basic health protection. The social health insurance model was markedly modified by the transition to the universal health care provision to all residents and there are strengthening tendencies to the split-off of the health insurance from the social insurance system; the result might be a transition to the NHS model or, on the contrary, to the neo-liberal mandatory private insurance system. The choice of the health care financing is a question a political, economic and social choice and the particular solution is not seldom also substantially influenced by the stakeholders. That is why there are also substantial deviations of the paradigmatic reforms from the corresponding theoretical models.

The aim of the article is to explore the doctor - patient relationship using the information asymmetry framework and principal-agent theory. From the perspective of economic exchange, this relationship is relatively specific, as an uneven rank and position of the agents involved play an important role here. It is argued that this unevenness arises from several different factors, such as education and qualification, work experience, path dependence, and the nature of goods and services provided. The relationship specificity is then discussed from a theoretical point of view while its most important elements are highlighted and put into a wider context. Further, market approach in healthcare system and healthcare services is partially debated and a simple model analyzing he "double-standard treatment is developed. Subsequently, this type of treatment is analyzed with the aid of vertical differentiation approach. Based on economic rationale, the authors claim that "medical knowledge/information obligation should play a crucial role in all healthcare services. This type of instrument is to be applicable for both parties in the doctor - patient relationship, as it may help overcome the inherently present information asymmetry by rendering the healthcare services provision more transparent.

Mental health has an economic impact on both individuals and societies. There is lack of information on total cost of mental illness in the Czech Republic, especially on social services financed by municipalities and private resources. In the health sector, the share of mental health expenditures is estimated to be 3-4 % of total health expenditures. In the social security system, mental illness is responsible for 3.3 % of total sick-days, 14.2 % of full disability pensions and 9.5 % of partial disability pensions. The estimated mental health expenditures amount 15 362 millions CZK in the health sector and from the social security in 2006, which makes 0.48 % of gross domestic product. If the level of expenditures on mental health is interpreted as an indicator of the society's commitment to mental health, then mental health has a relatively low priority in the Czech Republic.

This article focuses on common and different attributes of education and health from economic and social perspective. Education and health are not usually analyzed together so this could be considered to be an innovative approach. Article contains knowledge which reflects empirically known dependencies in the area of education and health determinants and relationships of education and health to human capital. It also emphasizes and argues for the importance of lifelong learning and availability of high-quality health care as economic development prerequisites. While the education and health is by its own nature bound to an individual and its investments, the question of equal chances to educate and consume health care is highly important in the modern society. Based on the identified attributes and relationships of education and health, the article shows their economic characteristic, social aspects and summarizes their importance for the economic development.

This paper provides an institutional analysis concerning the current problems of the health care systems based on obligatory health insurance. In the beginning there are correctly defined and further described some particular principles creating the essence of the continental health care systems. Consequently, there are described two major consequences of asymmetric information: the principal-agency problem and the problem of adverse selection. Further to the definitions there are drawn conclusions for appropriate system reforms.