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Are Health Problems Systemic? Politics of Access and Choice under Beveridge and Bismarck Systems

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Author Info
Zeynep Or () (IRDES institut for research and information in health economics)
Chantal Cases () (IRDES institut for research and information in health economics)
Melanie Lisac () (Bertelsmann Stiftung)
Karsten Vrangbaek () (University of Copenhagen)
Ulrika Winblad () (Department of Public Health and Caring Sciences Uppsala Univeristy)
Gwyn Bevan () (London School of Economics)

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Abstract

Industrialised countries face similar challenges for improving the performance of their health system. Nevertheless the nature and intensity of the reforms required are largely determined by each country's basic social security model. This paper looks at the main differences in performance of five countries and reviews their recent reform experience, focusing on three questions: Are there systematic differences in performance of Beveridge and Bismarck-type systems? What are the key parameters of health care system which underlie these differences? Have recent reforms been effective? Our results do not suggest that one system-type performs consistently better than the other. In part, this may be explained by the heterogeneity in organisational design and governance both within and across these systems. Insufficient attention to those structural differences may explain the limited success of a number of recent reforms.

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File URL: http://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT27AreHealthProblemsSysmetic.pdf
File Format: application/pdf
File Function: First version, 2009
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Publisher Info
Paper provided by IRDES institut for research and information in health economics in its series Working Papers with number DT27.

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Length: 29 pages
Date of creation: Sep 2009
Date of revision: Sep 2009
Handle: RePEc:irh:wpaper:dt27

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Related research
Keywords: Health system; Beveridge; Bismarck; reforms; performance;

Find related papers by JEL classification:
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
O57 - Economic Development, Technological Change, and Growth - - Economywide Country Studies - - - Comparative Studies of Countries

This paper has been announced in the following NEP Reports:

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This page was last updated on 2009-11-10.


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