Extract No 1: 
In 2015, publishing individual provider data became very rare and usually this data collected was inaccurate or false. There was no drive for more transparency in doctors’ performance and publishing outcomes per provider. The only source of information was the Statistical Office and the insurers. Although the rules for market entry were liberalized, it paradoxically did not lead to more transparency on the market. The patient pathways were based on personal contacts or on cash payments – formal or informal. 

There was no chance for a fair access to care.According to an independent study, the differences in access between urban and rural population as well as between the poor and rich were increasing. The system was in strong hand of industry driven providers and they set the rules. Which treatment is suitable, which drug is the best was solely their decision. The empowered patients were seen as “problematic”. Waiting lists were a very strong tool in providers’ hands and they were using them to skim the economic rent from the patient....
Extract No 2:
A phone call of two sisters (Jane and Kate)
Jane: Hi Kate, I need your help – our mum called me right now, that she needs to arrange a hip replacement for our dad. But don’t tell her I called you (sighs)
Kate: I had the suspicion, that something is going on, but you know, I didn’t want to ask them, they are always so organized.
Jane: Yeah, but in terms of healthcare they are rather disoriented, so they need some help and I think they are rather conservative and want to manage it by “their way”, you know what I mean?
Kate: Yes, I know. Ivan, one of my best friends is a doctor, so I will call him to ask for advice. He helped me also last time, when I needed a dermatologist. It was not cheap, but I did not have to wait and the doctor was very cute.
Jane: You mean you had to pay something extra?
Kate: Yes. But he works in a state hospital, so I had to pay him informally. 
Jane: And you think it will be the same situation in this case?
Kate: I think so, maybe we even have to pay more…
PS: In 2020, Ivan turned 46 years and became one of the best personal access brokers.During this phone call he did not even know that such a profession will be highly rewarded in the future.

Watch an artistic view on future where INDUSTRY DRIVES
The Broker

For full version of the Strategic Scenarios 2020: The Future of CEE Healthcare see pdf

The facilitator of development of the Strategic Scenarios 2020: The Future of CEE Healthcare was Ivan Perlaki. For more details please see his website:
© 2021 Central & East European Health Policy Network
CEE HPN brochure