Reconstructing the policy trajectory: pension and healthcare reforms in Albania

Due to economic and political changes in the early 1990s, as well as their own inherited inefficiencies, both pension and healthcare systems in Albania started to face major difficulties, most notably severe budget constraints due to the shaky economy and a need to adjust to the new economic order. Consequently, in 1993 the pension system underwent a parametric reform that conditioned benefits upon payment of contributions. Similarly, in 1994, the healthcare system shifted from Semashko to a Bismarckian model, with the introduction of a health insurance scheme. However, despite similar policy responses to deal with the challenges these two systems were facing, today, pension system has taken a different trajectory from healthcare. They differ from one-another in terms of financing method, coverage and benefits. Against this backdrop, the aim of this paper is to bring attention to important reforms in the pension and healthcare system that have had significant implications for the economic and social system. Its main focus will be to trace back the policy development of these two systems from their genesis to date – in order to understand the context in which certain decisions were taken. Moreover, it aims to reconstruct the policy trajectory of each system by using the appropriate conceptualisation based on Ferrera’s (1993) classification and corresponding definitions of solidarity models.