The Republic of Poland is the largest country in central and eastern Europe, in terms of both population (38.2 million) and area (312 685 square kilometres). In 1989, Poland was the first country among the central and eastern European countries to re-establish democracy after 44 years of communist rule. After a severe economic downturn in the early 1990s, Poland’s macroeconomic situation has stabilized, showing steady growth since the mid-1990s. In May 2004, Poland was admitted into the European Union (EU).
Poland has a mixed system for public and private health care financing. Social health insurance contributions represent the major public source of health care fiancing. Health insurance contributions are mandatory at a rate, in 2005, of 8.5% of its base, which corresponds for most people to taxable income. The National Health Fund (NHF) with its regional branches administers the social health insurance scheme, following the demise in 2003 of a decentralized system of 17 sickness funds, after just four years of existence. The NHF has the responsibility for planning and purchasing public financed health services. Health insurance contributions for certain groups of individuals not covered by the standard scheme and specific public health activities (such as the national health programmes which mainly focus on health prevention and promotion objectives) are funded directly by the state through general taxation. Complementary sources of financing include both formal and informal out-of-pocket payments, and to a lesser extent pre-payment schemes. Private health expenditure accounted for 27.5% of total health care expenditure in 2002. Around 60% of all out-of-pocket spending was on drugs and medical device.