The responsibility of the state to provide free, universally accessible and high quality health care for the entire population enjoys an even higher social and political consensus than observed in other OECD countries. A dense network of general practitioners, hospital and ambulatory services, maternity care and generous distribution of drugs and medical aids, all funded by public resources, provides wide health coverage. This has helped to achieve a remarkable improvement in the health status of the population since the early years of transition, at a pace unmatched in the region with the exception of Slovenia. However, cost pressures generated by the system threaten its sustainability. Policymakers’ understandable efforts to make state-of-the-art medical technologies accessible on a universal basis, the future impact of the ageing of the population on demand of services (and its structure), and pressure from health professionals and pharmaceutical companies to align their wages and prices with those in Western Europe are the main forces threatening the fiscal stability of the system.