The fall of centralized state planning and the onset of massive economic and social reform put new strains on Poland's health and welfare systems, whose nominally full and equal coverage had been increasingly faulty in the 1980s. In the last decade of communist rule, national health care suffered from poor material support, inaccessible medical personnel and facilities, and poor organization. At the same time, critical national health indicators for the 1970s and 1980s showed many negative trends. Likewise, access to social services, nominally equal for all workers, was limited by the availability of welfare funds in individual enterprises during the communist era. Because no national standards existed, some enterprises offered their employees no social services at all, while others offered a wide range. By 1989 the material position of low-income families and pensioners was especially desperate. The economic "shock therapy" begun in 1990 by the Balcerowicz Plan further reduced the level of guaranteed health and welfare services, to which a large part of Polish society had become accustomed under communist regimes (see Marketization and Stabilization , ch. 3).

Data as of October 1992