The Czech health care system has a great degree of decentralization and market forces used in it compared to other European systems, and the nation has faced substantial problems after the transition from Communist dictatorial rule to capitalistic democracy in the 1989-1992 period. From the past top-down centralized government system, the newly elected administrators enacted reforms designed to expand patient choice. From 1990 to 1998, deaths under one year of age shrank from 10.8 to 5.2 per thousand. Statistically, the Czech Republic is one of the healthiest of the central and eastern European countries, though some data points lag behind the more advanced Western European nations. The Republic has been a member of the Organisation for Economic Co-operation and Development (OECD) since 1995.
In terms of administration, the system is based on a compulsory insurance model, with fee-for-service care funded by mandatory employment-related insurance plans since 1992. User fees have subsequently been reduced by more recent governments.
In late-2000, professors of medicine Jan Holčík and Ilona Koupilová wrote for The International Journal of Integrated Care,
There is currently considerable interest in looking to Western Europe for inspiration and a certain degree of willingness to implement, what is usually described as, the European model of health care. The context of the situation in the Czech Republic, traditions with respect to social organisation and attitudes to health and health issues, and also the economic situation of the country, will all play an important role and pose many specific issues when trying to implement new concepts such as a family doctor. It remains to be seen how far these new concepts are effective and viable in the context of the Czech Republic.