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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 Vrangbaek (), Ulrika Winblad () and Gwyn Bevan ()
Additional contact information
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

No DT27, Working Papers from IRDES institut for research and information in health economics

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.

Keywords: Health system; Beveridge; Bismarck; reforms; performance (search for similar items in EconPapers)
JEL-codes: I18 O57 (search for similar items in EconPapers)
New Economics Papers: this item is included in nep-eec and nep-hea
Date: 2009-09, Revised 2009-09
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Downloads: (external link) ... ProblemsSysmetic.pdf First version, 2009 (application/pdf)

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Journal Article: Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systems (2010) Downloads
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