This is the first EAHMH biennial conference to be hosted in Eastern Europe. To date, Eastern Europe has received only limited attention from medical historians. Due to large political shifts, the history of the region is embracing new opportunities. While detailed regional studies are still required to uncover the pathways and processes of knowledge construction, the conference intends to foster discussions about how historians have considered the role of power and politics in the construction of medical knowledge.
The state, as we have come to know it, is very much a 19th-century creation. After poverty, ill health was the dominant social issue targeted by the interventions of emerging – states. Following the principle of the fair allocation of resources to meet basic social and economic needs, many countries introduced collective funding of health care in the 19th century. National healthcare systems came to epitomise the principle that all citizens have an equal right to health and that costs should be shared equitably. At the end of WWII, the WHO defined health as a universal human right. In the UN’s Universal Declaration of Human Rights (1948), it was proclaimed that “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including medical care”. Over the course of the 20th century, health and disease have become a matter of direct concern for the state. As an aspect of democratic citizenship, the provision of medical care is not considered a favour, but a civil right guaranteed by the state.
In recent decades, we have witnessed a globalisation of disease patterns, the rise of chronic disease, rapid technological change, spiralling healthcare costs, and the demise of the nation state. From 1990 onwards, we have seen heated public and political debates about the organisation and financing of collective healthcare. One key question has been: to what extent can the state be held responsible for the health of citizens and the practice of medicine? In many countries, collective arrangements were critically reconsidered, reformed or transferred to “the market”. Rationalisation and commercialisation brought in managers, who took control from professionals, creating new bureaucracies that to a large extent withdrew from democratic supervision. Triggered by the crisis of the welfare state since the 1980s and by the reassessment of the system of nation states since 1989, this conference sets out to rethink the role of the state in the domain of healthcare.