The operational character of a health system ultimately and crucially depends on its funding and organization (including herein the policies for collecting and managing funds). The public health system funding has been one of the most controversial issues undergoing debates throughout the past 20 years.
However, the management of the healthcare system was strictly centralized and rigid. The Government held complete monopoly over all healthcare services; no private medical care was allowed (the private-owned medical facilities were all abolished) and all health professionals were state-employed public servants.
Although several amendments were brought to the initial law, a new Health Act was passed only in 1978. Further on, in 1983 was legislated that certain service costs had to be supported by patients; however all medical care was still provided in state-owned medical facilities. The lack of any competition and/or private initiative resulted in poor-quality medical care services.