Coordinating health care under a pluralistic health insurance system: the case of Slovakia

Contains fulltext : 149245.pdf (Publisher’s version ) (Open Access) The Slovak approach to decreasing healthcare costs is based on a changed interpretation of the concept of ‘a minimum network of providers’. This study describes the changes made in the healthcare system in Slovakia in order to keep it affordable. It shows how the initial interpretation of a minimum network as an assurance for general access to healthcare services slowly changed into a cutback making the minimum network an upper limit for healthcare. The study argues that the complexity of the network made for non-transparent policies, in which consultation was nearly absent and vertical power became dominant, despite the semi-independence of actors in the network. This observation runs counter to the network theory suggestion that in complex networks, with semi-independent actors, vertical power becomes useless. 17 p.