Health Care Reforms in Europe: Convergence towards a Market Model?

Dr. Ines Verspohl

doi:10.5771/9783845235370

Summary

Wettbewerb und Privatisierung sollen die Gesundheitssysteme effizienter und kundenorientierter machen. Ausgehend von der Wohlfahrtsstaatenforschung, die Gesundheit bisher vernachlässigt hat, untersucht dieses Buch, ob und wie weit Marktelemente in die Gesundheitssysteme der Niederlande, Deutschland und Schwedens eingebaut wurden.

Die Analyse zeigt, dass trotz des gleichen Problemdrucks – demographischer Wandel, medizinisch-technische Innovationen, Staatsverschuldung – die Marktidee durch die nationalen Ideen und Institutionen anders umgesetzt wurde. Während Deutschland und die Niederlande Wettbewerb zwischen den Krankenversicherungen einführten, setzte Schweden auf Wettbewerb zwischen den Ärzten.

Eine gesonderte Analyse des Einflusses der Europäischen Union auf die nationalen Reformen zeigt, dass die Offene Methode der Koordinierung im Bereich Gesundheit und Langzeitpflege kein Vorbild propagierte und damit auch keinen weichen Einfluß ausüben konnte. Obwohl die EU eigentlich keine Kompetenz für die sozialen Sicherungssysteme besitzt, hatten der Binnenmarkt und die Marktfreiheiten mehr Einfluß als die OMK.

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Bibliographic data

Edition: 1/2012
Copyright Year: 2012
ISBN-Print: 978-3-8329-7071-0
ISBN-Online: 978-3-8452-3537-0
Publisher: Nomos, Baden-Baden
Series: Schriften zur europäischen Arbeits- und Sozialpolitik
Volume: 10
Language: English
Pages: 328
Product Type: Monograph

Titelei/Inhaltsverzeichnis No access Pages 2 - 12
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List of Figures No access Pages 13 - 14
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1. Dutch abbreviations and terms No access
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2. Swedish abbreviations and terms No access Pages 16 - 16
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3. German abbreviations and terms No access Pages 16 - 16
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1. Scope No access Pages 17 - 20
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2. Health and Health care No access Pages 20 - 21
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3. Data sources No access Pages 21 - 22
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4. Outline No access Pages 22 - 24
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1. 1. Structural factors in health care No access Pages 25 - 28
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  2. Power-resource approach No access Pages 28 - 29
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  3. Conclusion Structuralism No access Pages 29 - 30
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2. 1. Three forms of new institutionalism No access Pages 30 - 34
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  2. Incremental change No access Pages 34 - 35
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  3. Authors:
    1. Social Health Insurance No access
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    2. National Health Service No access
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  4. Conclusion Institutionalism No access Pages 38 - 38
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3. 1. Authors:
    1. Liberal medicine No access
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    2. Solidarity No access
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    3. The market idea No access
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    4. Inherent problems of a health care market No access
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  2. Conclusion Ideas No access Pages 45 - 45
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4. Conclusion Theory No access Pages 45 - 46
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1. Europeanization / Globalisation No access Pages 47 - 52
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2. 1. Political institutions No access Pages 52 - 53
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  2. Authors:
    1. Pharmaceuticals No access
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    2. Free movement of blood and organs No access
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    3. Patient mobility No access
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    4. Free movement of health professionals No access
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    5. Private health insurances No access
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    6. Competition law No access
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  3. Conclusion Institutional impact No access Pages 62 - 63
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3. 1. Open Method of Coordination in health and long-term care No access Pages 63 - 68
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  2. Commissions favourite No access Pages 68 - 71
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  3. Conclusion OMC No access Pages 71 - 72
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4. Conclusion EU impact No access Pages 72 - 74
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  1. Convergence No access
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2. 1. Governance No access Pages 77 - 79
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  2. Funding No access Pages 79 - 81
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  3. Provision No access Pages 81 - 82
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  4. Remuneration No access Pages 82 - 84
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  5. Access No access Pages 84 - 86
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3. Conclusion methodology No access Pages 86 - 88
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  1. Health status No access
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2. 1. Political institutions No access Pages 93 - 96
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  2. Welfare state No access Pages 96 - 97
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  3. Institutional legacy No access Pages 97 - 100
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3. Discourse No access Pages 100 - 101
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4. Authors:
  1. Reform history No access
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5. 1. Competition No access Pages 110 - 113
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  2. Governance of Insurances No access Pages 113 - 116
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  3. Governance of Physicians No access Pages 116 - 116
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  4. Liability No access Pages 116 - 117
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  5. Conclusion governance No access Pages 117 - 117
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6. 1. AWBZ No access Pages 117 - 120
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  2. Authors:
    1. ZfW No access
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    2. Private Insurance No access
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    3. Others No access
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    4. New System No access
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  3. Third compartment – supplementary insurances No access Pages 126 - 127
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  4. Summery funding No access Pages 127 - 130
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7. 1. Ambulatory care No access Pages 130 - 133
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  2. Stationary care No access Pages 133 - 135
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  3. Pharmaceuticals No access Pages 135 - 136
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  4. Dental care No access Pages 136 - 137
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  5. Conclusion Provision and Remuneration No access Pages 137 - 137
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8. 1. Benefit package and health technology assessment No access Pages 137 - 139
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  2. Inequality No access Pages 139 - 140
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9. 1. Functionalist retrenchment No access Pages 140 - 143
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  2. Institutions No access Pages 143 - 143
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  3. Market idea No access Pages 143 - 145
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  4. Europeanization No access Pages 145 - 146
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10. Final Conclusion No access Pages 146 - 148
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  1. Health Status No access
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2. 1. Authors:
    1. National level No access
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    2. Regional level No access
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    3. Municipalities No access
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  2. Welfare State No access Pages 155 - 156
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  3. Institutional legacy No access Pages 156 - 160
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3. Discourse No access Pages 160 - 163
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4. Authors:
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    1. ÄDEL-reform No access
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    2. Tax stop No access
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    3. Waiting list reform No access
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    4. Family doctor reform No access
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    5. Start- and stop law No access
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5. 1. Devolution No access Pages 165 - 166
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  2. Authors:
    1. Health inequality No access
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    2. Liability No access
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  3. Authors:
    1. Choice No access
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    2. Quality assurance No access
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  4. Authors:
    1. Purchaser-provider-split No access
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    2. Money follows the patient No access
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    3. Conclusion Privatisation No access
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  5. Conclusion Governance No access Pages 172 - 173
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6. 1. Authors:
    1. Tax revenues No access
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    2. Equalisation No access
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    3. Situation today No access
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    4. Social Insurance No access
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  2. Authors:
    1. Private insurance No access
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  3. Conclusion Funding No access Pages 181 - 182
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7. 1. Authors:
    1. De-hospitalisation No access
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    2. Regional differences No access
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    3. Shared responsibility No access
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  2. Authors:
    1. Primary care No access
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    2. Regional differences No access
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    3. Hospitals No access
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  3. Public Health No access Pages 196 - 196
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  4. Dental care No access Pages 196 - 198
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  5. Pharmaceuticals No access Pages 198 - 200
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  6. Conclusion Provision No access Pages 200 - 201
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8. 1. Waiting lists No access Pages 201 - 204
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  2. Prioritization No access Pages 204 - 204
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  3. Co-payments No access Pages 204 - 205
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  4. Inequality No access Pages 205 - 206
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  5. Conclusion access No access Pages 206 - 206
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9. 1. Functionalist retrenchment No access Pages 206 - 207
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  2. Path-dependent Institutions No access Pages 207 - 209
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  3. Market Idea No access Pages 209 - 210
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10. Final conclusion No access Pages 210 - 210
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  1. Health Status No access
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2. 1. Political Institutions No access Pages 213 - 216
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  2. Welfare state institutions No access Pages 216 - 218
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  3. Institutional legacy for health No access Pages 218 - 221
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3. 1. Reform discourse No access Pages 221 - 227
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  2. Other actors No access Pages 227 - 227
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  3. Private Insurances No access Pages 227 - 228
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  4. Conclusion Discourse No access Pages 228 - 229
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4. Authors:
  1. Reform history No access
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5. 1. Authors:
    1. Internal governance of insurances No access
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    2. Competition No access
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    3. Governance of the remuneration system No access
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    4. Selective contracts No access
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  2. Authors:
    1. Governance of remuneration No access
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    2. Conclusion PKV No access
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  3. Governance of Providers No access Pages 241 - 242
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  4. Liability No access Pages 242 - 242
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  5. Conclusion Governance No access Pages 242 - 243
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6. 1. Authors:
    1. Deductibles, no-claims, and premium No access
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    2. Tax subsidies No access
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  2. Out-of-pocket payments No access Pages 249 - 251
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  3. Private health insurance No access Pages 251 - 252
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  4. Civil servants No access Pages 252 - 253
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  5. Uninsured No access Pages 253 - 253
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  6. Hospital investment No access Pages 253 - 254
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  7. Other sources of funding No access Pages 254 - 255
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  8. Conclusion funding No access Pages 255 - 257
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7. 1. Authors:
    1. Remuneration of ambulatory care No access
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    2. Remuneration of care for Private Patients No access
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  2. Authors:
    1. Hospital personnel No access
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    2. Quality assurance No access
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  3. Provision of non-medical benefits No access Pages 266 - 267
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  4. Dental care No access Pages 267 - 267
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  5. Authors:
    1. Co-payments and private purchases No access
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  6. Conclusion Provision No access Pages 269 - 271
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8. 1. Benefit package No access Pages 271 - 273
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  2. Inequality No access Pages 273 - 273
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  3. Conclusion Access No access Pages 273 - 274
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9. 1. Functionalist retrenchment No access Pages 274 - 276
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  2. Institutional path-dependency No access Pages 276 - 277
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  3. Market idea No access Pages 277 - 278
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  4. Europeanization No access Pages 278 - 278
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10. Final conclusion No access Pages 278 - 278
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1. 1. Competition for members No access Pages 279 - 282
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  2. Selective Contracts No access Pages 282 - 283
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  3. Competition for patients No access Pages 283 - 284
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  4. Direct markets in dental care No access Pages 284 - 285
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  5. Pharmaceuticals No access Pages 285 - 286
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  6. Conclusion Competition No access Pages 286 - 287
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2. 1. Provision No access Pages 287 - 288
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  2. Funding No access Pages 288 - 290
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  3. Access and equality No access Pages 290 - 290
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  4. Conclusion Privatization No access Pages 290 - 291
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3. 1. Volume and Expenditures No access Pages 291 - 293
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  2. Solidarity No access Pages 293 - 294
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  3. The role of the state No access Pages 294 - 296
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4. Conclusion Convergence No access Pages 296 - 298
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1. Mediated problems No access Pages 299 - 302
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2. Adapted solutions No access Pages 302 - 303
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3. Hampered implementation No access Pages 303 - 305
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4. Drift - Change without reform No access Pages 305 - 305
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5. Impact of the EU No access Pages 305 - 307
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6. Welfare state theory No access Pages 307 - 308
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7. Overall conclusion No access Pages 308 - 310
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Biobliography No access Pages 311 - 328
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