Estonia: shifting focus from the crisis to the future

The new HiT health system review on Estonia describes Estonia's vigorous response to the 2008 financial crisis. Estonia indeed employed a tough austerity package with cuts in benefits and prices, increased cost sharing for certain services, extended waiting times, and a reduction in specialised care. While concerns about the future impact of some of these cuts remain, all in all Estonia seems to have managed quite successfully and its experience may hold important lessons for countries still dealing with the consequences of the economic downturn.

The country should now start focusing again on some of the pre-crisis challenges, which include ensuring sustainable health financing, guaranteeing a sufficient level of human resources, prioritising patient-centred health care, integrating health and social care services, implementing intersectoral action, safeguarding access to health care for lower socioeconomic groups, and lastly improving evaluation and monitoring. Whereas positive trends in increasing life expectancy and reducing infant mortality persist, some important public health challenges need to be tackled: the still high rates of smoking and alcohol consumption, as well as increasing obesity rates.

This new report will be formally launched at the WHO Follow-up meeting on the 2008 Tallinn Charter in Tallinn: Health Systems for Health and Wealth in the context of Health 2020 (17 - 18 October 2013).