Virtually all countries report a gap between the budget allocated for health care and the demand placed on the system by its users. This gap is more pronounced in developing countries, and is even further exacerbated in a transitional country like Serbia and Montenegro (S&M). This country experienced more than a decade of civil war and international isolation in addition to its transition from communism to a market economy. SWOT analysis has identified the main weaknesses of the S&M public health care system as insufficient funding, low quality and ineffectiveness, lack of continuing education for medical professionals and their low motivation. Funding pressure has led to a search for cost-containment measures and inevitably results in various forms of „rationing“ or „priority setting“ which translates into an unequal access to health care and periodic protests and strikes of health workers demanding higher pay. Interestingly enough, in Serbia and Montenegro, there appears to be no visible and/or organized patient (citizen) protest to demand improvements in public services.
On the basis of positive experiences in some developed countries (e.g. UK, the Netherlands) and some developing countries (e.g. India), we propose a three-pronged reform model:
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rationing of health care as a temporary „stop-gap“ solution,
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general management system overhaul and
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introduction of Complementary and Alternative Medicine (CAM) as an example of increased resource productivity.
Keywords:
Public health care, Serbia and Montenegro, Complementary and Alternative Medicine.
Schlüsselwörter:
Öffentliches Gesundheitswesen, Serbien und Montenegro, Komplementäre und Alternative Medizin.
Korrespondierender Autor: Liliana Goliani DMD, Ph.D, D.Hom.Med, Oivivio Holistic Center, Kneginje Zorke 9A/21, 11000 Belgrade, Serbia
E-Mail: liliana@oivivio.net
