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Health Care Reforms in Europe

Convergence towards a Market Model?
Authors:
Publisher:
 2012

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.

Bibliographic data

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

Table of contents

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

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