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Since 1989 there have been enormous changes in all aspects of health p olicy, and the Former Socialist Economies (FSEs) are facing similar ch allenges. The general restructuring of politics and economies has resu lted in two leading orientations in the transformation of health care systems: the separation of funding and service provision from the star e, and the separation of funding and service provision from each other . Many FSEs have already passed legislation establishing a sickness in surance system under a single national funding institution, or a combi nation of compulsory and voluntary insurance, or a system involving pr ivate sector insurance companies in generating compulsory or voluntary health care funding. Due to the peculiarities and specific features o f the German health care system, the uncritical intention to implement the ''Bismarck model'' in the FSEs faces several problems. These can be summarized in one main point: the relative stability of the German health care system, which may be attractive to the FSEs, is based on e conomic prosperity and on a strong ability to assert the will of the c entral state institutions; these preconditions are not present in the FSEs.