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Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systems

  • Or, Zeynep
  • Cases, Chantal
  • Lisac, Melanie
  • Vrangbæk, Karsten
  • Winblad, Ulrika
  • Bevan, Gwyn

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. Most reforms in Beveridge-type systems have sought to increase choice and reduce waiting times while those in major Bismarck-type systems have focused on cost control by constraining the choice of providers. 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 healthcare system, which underlie these differences? Have recent reforms been effective?

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Article provided by Cambridge University Press in its journal Health Economics, Policy and Law.

Volume (Year): 5 (2010)
Issue (Month): 03 (July)
Pages: 269-293

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Handle: RePEc:cup:hecopl:v:5:y:2010:i:03:p:269-293_00
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  1. P.C. Smith, 2002. "Measuring health system performance," The European Journal of Health Economics, Springer, vol. 3(3), pages 145-148, September.
  2. Sandy Tubeuf & Florence Jusot & Marion Devaux & Catherine Sermet, 2008. "Social heterogeneity in self-reported health status and measurement of inequalities in health," Working Papers DT12, IRDES institut for research and information in health economics, revised Jun 2008.
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  5. Zeynep Or & Chantal Cases & Melanie Lisac & Karsten Vrangbaek & Ulrika Winblad & Gwyn Bevan, 2009. "Are Health Problems Systemic? Politics of Access and Choice under Beveridge and Bismarck Systems," Working Papers DT27, IRDES institut for research and information in health economics, revised Sep 2009.
  6. Carine Franc & Marc Perronnin & Aur�lie Pierre, 2008. "Private Supplementary Health Insurance: Retirees' Demand," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan, vol. 33(4), pages 610-626, October.
  7. Thierry Debrand & Aurélie Pierre & Caroline Allonier & Veronique Lucas-Gabrielli, 2008. "Health status, Neighbourhood effects and Public choice: Evidence from France," Working Papers DT11, IRDES institut for research and information in health economics, revised Jun 2008.
  8. Nicolas Sirven & Brigitte Santos-Eggimann & Jacques Spagnoli, 2008. "Comparability of Health Care Responsiveness in Europe using anchoring vignettes from SHARE," Working Papers DT15, IRDES institut for research and information in health economics, revised Sep 2008.
  9. Yilmaz, Engin & Jusot, Florence & Or, Zeynep, 2008. "Impact of health care system on socioeconomic inequalities in doctor use," Economics Papers from University Paris Dauphine 123456789/7006, Paris Dauphine University.
  10. Michel Naiditch & Paul Dourgnon, 2009. "The preferred doctor scheme: A political reading of a French experiment of Gate-keeping," Working Papers DT22, IRDES institut for research and information in health economics, revised Mar 2009.
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  12. Michel Grignon & Bidénam Kambia-Chopin, 2009. "Income and the Demand for Complementary Health Insurance in France," Working Papers DT24, IRDES institut for research and information in health economics, revised Apr 2009.
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