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: Book Titles

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