Lebanon's health care policy: a case study in the evolution of a health system under stress.

Lebanon's experience in the development of its health care system over the last century is reviewed; inasmuch as experiences can be generalizable, the case of Lebanon reflects the attempts of middle-income countries to balance the public and private sectors' roles in health care. Lebanon's health care system followed a predictable trend that was accelerated and intensified by the civil disturbances during the past decade. Its main feature has been the absence of a coherent and sustained health policy that promotes a stable and long-lasting relationship between the public and the private sectors in health. The role of the State has been most effective during periods of political, social and economic stability, when serious planning efforts could be undertaken and resultant policies be implemented. An effective partnership between the State and the private sector is recommended for the reconstruction of Lebanon's health care system, as well as for other countries with a strong private sector involvement in health care.