Bosnia And Herzegovina

Abstract

Abstract This chapter offers an in-depth look at health politics and the social health insurance system in the separate entities that make up Bosnia and Herzegovina. It traces the development of the healthcare system in Bosnia and Herzegovina, marked by the introduction of self-managed insurance system during communism. After Bosnia and Herzegovina declared independence in 1992 following the breakup of the SFRY, the health system deteriorated during the devastating Bosnian War, and the nation-building process dominated the political agenda. Since 1996, facilitated by international organizations, health politics has focused on remodeling the socialist self-managed insurance system towards a more standard social insurance system with market elements. While the Republika Srpska entity has a centralized social insurance system, in the Federacija Bosne i Hercegovine entity the social insurance is decentralized, governed independently by ten cantons. As described in the chapter, the main healthcare issues have been the significant portion of uninsured, inequalities in health access both across and within regions, the high cost of private health services, and difficulties with collecting sufficient insurance contributions due to high rates of unemployment and informal employment.