Each country in Central and Eastern Europe has developed a variety of strategies for implementing interventions and improvements in their health care delivery system. Transformation efforts in the Slovak Republic have focused on decentralization, privatization, democratization and liberalization. While the pressures for change have unevenly fallen throughout Central and Eastern Europe, the Slovak Republic has initiated structural changes, particularly in the area of privatization. The concept of privatization requires further discussion especially when considering the principle of subsidiarity and the need to develop coherent social structures. Areas for structural changes in the Slovak Republic are examined in the area of privatization of transformation efforts. Characteristics of successful voluntary organizations in private economies are discussed with appropriate future concerns identified for further analysis.