Coordinating Healthcare Under a Pluralistic Health Insurance System: The Case of Slovakia

Juraj NEMEC, David SPACEK, Michiel de VRIES


The Slovak approach to decreasing health-care costs is based on a changed interpretation of the concept of ‘a minimum network of provid-ers’. This study describes the changes made in the healthcare system in Slovakia in order to keep it affordable. It shows how the initial inter-pretation of a minimum network as an assurance for general access to healthcare services slow-ly 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 consulta-tion was nearly absent and vertical power be-came 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.


healthcare coordination, semi-in-dependent institutions, networks.

Full Text:

Creative Commons License
Transylvanian Review of Administrative Sciences by TRAS is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at

Online ISSN: 2247-8310 | Print ISSN: 1842-2845 |  © AMP

The opinions expressed in the texts published are the author’s own and do not necessarily express the views of TRAS editors. The authors assume all responsibility for the ideas expressed in the materials published.