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

Zeynep Or (), Chantal Cases (), Melanie Lisac, Karsten Vrangbæk, Ulrika Winblad and Gwyn Bevan

Health Economics, Policy and Law, 2010, vol. 5, issue 03, 269-293

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. 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?

Date: 2010
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