Having discussed the principles that apply to the whole welfare sector, the rest of the book is solely concerned with the health sector. Each branch of the welfare sector has specific features. This means they cannot all be reformed along the same lines. Indeed it is widely agreed that health care differs strongly from other social services, and that its specific characteristics require close attention when reforms are being planned and implemented. This chapter examines these special features.

A general overview

We focus on the universal characteristics of the health sector, which apply in all countries and under all socio-economic systems. Later chapters discuss features specific to historical conditions in Eastern Europe.

Few if any of the characteristics examined here, when considered separately, are unique to health care. Several may be found in other areas as well. The specificity of the health sector stems from possession of all these characteristics at once. Furthermore, some characteristics assert themselves with great intensity.

The value attached to health

Health is a state that most people attach great value to gaining and keeping. Although this may seem obvious and trivial, it deserves to be mentioned first. Health is not the prime consideration for everyone – some people put other goals before it – but the preference expressed as “health comes first” is the predominant one.