Healthcare workers in all surveyed countries - from Czech Republic to Moldova - complained of earning less than national average and of crippling wage arrears. In some countries - Armenia, Moldova, Kyrgyzstan - few bother to clock in anymore. In others - Poland and Latvia, for instance - a much abbreviated working week and temporary labor contracts are imposed on reluctant and restive healthcare workers.

One in twenty hospitals in Poland had to close between 1998-2001. In an impolitic spat of fiscal devolution, ill-prepared local authorities throughout region were left to administer and finance shambolic health services within their jurisdictions.

The governments of east Europe tried to cope with this unfolding calamity in a variety of ways.

Consider Romania. Half population claim to be "very satisfied" with its health services.

In Romania, 1997 Health Insurance Law shifted revenue collection and provider payments to a maze-like coalition of 41 district health insurance houses (HIH) headed by a National Health Insurance House. Romanian citizens are forced to foot one third of their health bills in a country which spends a mere 3 percent of GDP on salubrity of its citizens - equivalent of $100 per year per capita. Only a small part of this coerced co-financing is formal and legal.

About 70 percent of meager state budget is derived from erratic payroll health insurance fund contributions, now set at 14 percent of wages. The national budget supplements rest. Some of contributions are distributed among poorest regions to narrow inequality between urban and rural areas.

The HIH's pay health care providers, such as hospitals based on capitation, or a projected global budget. They are experimenting now with fee-for-service reimbursement methods. All these payment systems, inevitably, are open to abuse. Monitoring and auditing are poor and relations are incestuous.

The Ministry of Health still makes all major procurement decisions. Many government organs - Ministry of Interior, transport system, Army - all maintain their wastefully parallel care provision networks. Donor funds, multilateral financing, and government money have all vanished into this insatiable sink of venality.

The only rays of light are private dental and medical clinics, laboratories, and polyclinics working side by side with private pharmacies and apothecaries. These cater to well-to-do. But government emulated them and "privatized" institution of family physician (general practitioner).

GP's now receive, on a contractual basis, payment per socially-insured patient treated. They make rent-free use of clinics and equipment in their workplace. Many of these doctors now borrow small amounts from willing banks - a scarcity in Romania - to open their own practice.

In an article published on March 2000 in "Central Europe Review" and titled "Trying our Patients", Professor Pavel Pafko, Head of Third Surgery Department, Charles University Faculty Hospital, Prague, lamented state of Czech medicine:

"After 1989 Velvet Revolution, there were fundamental changes in health service: market was opened to manufacturers of medical equipment, aids and medicines, and Parliament announced right for everyone to choose their own doctor. In my opinion, health service was not sufficiently prepared for these fundamental changes.

In public's mind idea of 'free health care' survived and continues to survive from Communist period, as does idea that all of us are equal as long as we are healthy. The sick man in many cases loses this equality and cannot himself pay by legal means for what state, or rather insurance companies, have no resources to provide."

Expenditure on health amounted in 1990's to c. 7 percent of GDP per year (compared to 14 percent of a much larger GDP in OECD countries). But medical insurance firms cannot cope with vertiginous prices of imported medicines. Hospitals now receive insufficient lump-sum payments rather than getting reimbursed for procedures and treatments carried out. Naturally, most of these go towards staff wages. Little is left for medical care.

Poland is in no better shape. Its embattled minister of health, Mariusz Lapinski, stumbles from crisis to criticism in his doomed effort to reform a ramshackle system. The two current scandals involve heavily and unsustainably subsidized drugs and a new health bill, fiercely opposed by progressive interests, such as medical doctors and nurses. The Polish weekly, Wprost, went as far as comparing Poland's healthcare to Egypt's, Turkey's, and Mexico's.

The World Bank discovered in 1998 that 78 percent of Poles had to pay illicitly to obtain basic care. Lapinski intends to dissolve regional state health funds and resurrect them in form of a national edition. But state-run hospitals in Poland are insolvent. Naturally, healthcare workers have little faith in management skills of state.

They are calling for open competition among teams of commercial health insurance funds and health care providers. They would also like to increase health insurance contributions to allow Poland to spend on health more than current 5.5 percent of GDP.

UPI reported recently ("Shock Therapy in Macedonian Healthcare") about a strike of medics in Macedonia as typical of problems facing healthcare systems of all countries in transition: privatization, involvement of state, and Western influence of reform process. The transition to western General Practitioner (GP) model is hotly debated. As far as doctors are concerned, it is a lucrative proposition. But it could exclude poorer patients from medical care altogether.

Still, main problem is gap between grandiose expectations and self-image - and shabby reality. East European medicine harbors fantastic pretensions to west European standards of quality and service. But it is encumbered with African financing and Vietnamese infrastructure. Someone must bridge this abyss with loads of cash. Either government, or consumer must cough up funds. The sooner everyone come to terms with this stressful truth - healthier.

Heart diease is not just an old person's diease. In summer of 2002 Darryl Kyle a 33-year-old professional baseball pitcher died in his sleep. The autosy showed that he had 80% to 90% narrowing of two of three cornary arteries. As important as exercise is, it is clearly not entire answer. A scientific study found that every 15-year-old already had plaque build up! The obvious conclusion was that cardiovascular diease was starting in childhood.

The efficiency of our immune system will, to a large degree, determine our cardiovascular health. Nutrionally supporting our cardiovascular system with a combination of transfer factor and other key ingredients is something we can do to help insure a long healthy life.