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Poland enacted in 1997 legislation that founded a health care system in which health insurance societies contract with providers to deliver health services to the insured population. Through a review of the new statutes, interviews with key informants, analysis of public opinion polls and surveys of insurance administrators and health care workers, we examined the impact of reform on Poland's older citizens. The findings indicate that older adults are likely to be adversely affected by the inadequacies of insurance premiums as a source of finance, the lack of emergent private medical enterprise, and the failure to eradicate private health in its earlier, black market incarnation. KEYWORDS. Poland, health care, health reform, geriatric care, older adults