Health Care Systems in Europe under Austerity: Institutional Reforms and Performance (Work and Welfare in Europe)

This book analyses recent reform trends of European health care systems. Using eight European countries case studies it connects policy reforms with a healthcare quadrilemma, and compares how well these systems perform in terms of economic efficiency, medical achievements, social inequalities, and responsiveness to patients and workers. Health care is a central pillar of the welfare state, in fact, the second pillar in terms of expenditure after pensions. However, we know little about how they perform. European health care systems have been put increasingly under pressure during the last two decades. They have had to face a quadrilemma : to control costs and the increase in public expenditure; to guarantee equality of access; to maximize the quality of care; and to guarantee the responsiveness of the health system and the satisfaction of patients and professionals working in the field. Achieving good results on all these four objectives is extremely difficult and often trade-offs arise among different objectives. Using in-depth case study analysis on eight health care systems, belonging to different Welfare State traditions, and comparative statistical analysis on a broader group of countries, the book connects the main policy reforms of the last two decades with how well these systems perform, in terms of economic efficiency, medical achievements, social inequalities, and patients' and workers' conditions.--[Source inconnue] Health Care is a central pillar of the Welfare State, in fact, the second pillar in terms of expenditure after pensions. However, we know little about how they perform. European Health Care Systems have been put increasingly under pressure during the last two decades. They have had to face a quadrilemma: to control costs and the increase in public expenditure; to guarantee equality of access; to maximize the quality of care; and to guarantee the responsiveness of the health system and the satisfaction of patients and professionals working in the field. Achieving good results on all these four objectives is extremely difficult and often trade-offs arise among different objectives. Using in-depth case study analysis on eight health care systems, belonging to different Welfare State traditions, and comparative statistical analysis on a broader group of countries, the book connects the main policy reforms of the last two decades with how well these systems perform, in terms of economic efficiency, medical achievements, social inequalities, and patients' and workers' conditions -- Provided by Publisher Front Matter....Pages i-xvii Introduction....Pages 1-6 Front Matter....Pages 7-7 Sweden: Continued Marketization within a Universalist System....Pages 9-30 England: Health Reforms Have Improved the NHS....Pages 31-56 Spain: Quo Vadis? From Cost Containment to Structural Reforms....Pages 57-80 Italy: A Strange NHS with Its Paradoxes....Pages 81-101 France: Squaring the Health Spending Circle?....Pages 102-125 Germany: Mixing Rescaling, Privatization and Managerialism....Pages 126-146 Austria: A Health Care System between Continuity and Gradual Changes....Pages 147-168 Poland: Decentralization, Privatization and Managerialization of the Health Care System....Pages 169-189 Front Matter....Pages 191-191 The Health Care Policy Quadrilemma and Comparative Institutional Reforms....Pages 193-221 The Performance of European Health Care Systems....Pages 222-255 Health Care Provision: An Exploratory Analysis of Increase, Decline, Converging Trends and Driving Forces in Comparative Perspective....Pages 256-270 Conclusions....Pages 271-277 Back Matter....Pages 278-312