Health Care Systems In Europe Under Austerity

This book analyses recent reform trends of European health care systems. Using eight European countries case studies it connects policy reforms with a healthcare quadrilemma, and compares how well these systems perform in terms of economic efficiency, medical achievements, social inequalities, and responsiveness to patients and workers.

This book addresses the global need for more comparative studies on health policy and health care systems, given the rise in recent decades of societal aging, modern mass diseases, economic globalization, and resulting permanent fiscal austerity of governments which have fundamentally altered the status quo of health care systems. The book examines the healthcare experiences of the most developed countries in Asia (Japan, South Korea, Taiwan and Singapore) and compares these with four of the most important health care systems in Europe (UK, France, Germany and Italy). Focusing on the public health care systems the contributors discuss the rising need for reforms in health care and health insurance administration, delivery systems, financing and overall health care policy strategies, particularly in fast-aging societies in Asia, and highly aged societies in Europe. This book will appeal to students and scholars of health care policy, health and social administration, social policy, public policy and social work. It will also provide a reference for professionals who need a view of the trajectory of public health financing in relation to changed and changing demographics and disease patterns.

Public social services are a key component of the welfare state in most of Europe, although their development trajectories, coverage and legal status still vary considerably among countries. How such services are provided and for whom impacts significantly on social and territorial cohesion, gender balance and, ultimately, on the development of any society. However, while much is discussed and written about social policy and welfare systems, social services remain somewhat neglected. Although they have gained a stronger foothold in national legislations and social policy agendas, their status remains weaker compared to education or health. Moreover, because of the austerity measures following the 2008 financial crisis, they have been subject to cuts and reorganisation, which have brought about significant disruption. This book revives the discussion on public social services and their redesign, with a focus on services relating to care and the social inclusion of vulnerable groups. Conveying the main findings of the EU-funded COST Action IS1102 Social Services, Welfare States and Places, the book provides rich information on the changes that occurred in the organisation and supply of public social services over the last thirty years in different European places and service fields. Despite the persisting variety in social service models, three shared trends emerge: public sector disengagement, 'vertical re-scaling' of authority and 'horizontal re-mix' in the supply system.

This book deals with the critical empirical void created by the speed at which healthcare restructuring has taken place in Europe. Chapters explore the political uncertainty and budgetary pressures which have led governments increasingly to turn to New Public Management (NPM)-style reforms to attempt to balance the financial viability of public health structures, with democratic imperatives to maintain socially just outcomes. The authors of this volume consider how governments have therefore shifted identities from principal care providers to contractual monitors, setting targets increasingly directed toward third-party managers in quasi-markets and the private sector. Drawing upon extensive data from Germany, Norway, the Netherlands, and Israel, the contributions explore the often unexpected policy outputs and outcomes engendered by such reforms.

This book draws on research within neo-Weberian and neo-institutionalist perspectives to critically analyse National Health Services (NHSs) in Western Europe. Exploring the challenges posed by neo-liberal policies, it also looks at the impact of the role of the state, the medical profession, the public and the medical–industrial complex in their development. Bringing together a top-line range of expert international contributors, this book includes national studies from three European macro-regions: Britain, Scandinavia and the Mediterranean. In the first part, the NHSs of each country considered are examined historically and in a contemporary context in face of emerging challenges – from cost containment to governance. The second part looks across the macro-regions at the influence of the main actors involved in their evolution and sustainability. Comparing and contrasting the NHSs of Western Europe, the book ends with a discussion of future directions. This book makes a vital contribution at a time when health services globally have been under great pressure in the wake of the COVID-19 pandemic. It is written for academics and advanced students of healthcare, management, public policy, social policy and sociology – in addition to health professionals and policymakers.

Economic shocks pose a threat to health and health system performance by increasing people's need for health care and making access to care more difficult - a situation compounded by cuts in public spending on health and other social services. But these negative effects can be avoided by timely public policy action. While important public policy levers lie outside the health sector, in the hands of those responsible for fiscal policy and social protection, the health system response is critical. This book looks at how health systems in Europe reacted to pressure created by the financial and economic crisis that began in 2008. Drawing on the experience of over 45 countries, the authors:' analyse health system responses to the crisis in three policy areas: public funding for the health system; health coverage; and health service planning, purchasing and delivery 'assess the impact of these responses on health systems and population health' identify policies most likely to sustain the performance of health systems facing financial pressure' explore the political economy of implementing reforms in a crisisThe book is essential reading for anyone who wants to understand the choices available to policy-makers - and the implications of failing to protect health and health-system performance - in the face of economic and other forms of shock.--

The current climate of fiscal austerity poses significant challenges for the health of populations across Europe. Deteriorating social conditions make some groups of individuals especially vulnerable to illness and have the potential to exacerbate existing inequalities in health and in access to healthcare. These challenges are occurring alongside other significant trends, such as: the integration of health and social services; a growing emphasis on individual responsibility for health and lifestyles; the pharmaceuticalization of everyday life; and the increasing deterioration in the mental health of people in contemporary societies. The work of healthcare professionals is also undergoing significant changes, as their work comes under increased surveillance and monitoring, raising implications for the relations with patients, for the kind of care that is provided, and for the experience of patients. In different ways, and based on different cases, this book deals with challenges for health and healthcare in a European context. This includes challenges on an individual level, such as individual views and behaviour, and on a societal level, such as inequality. The book applies to students, researchers, healthcare professionals, and decision-makers within health and healthcare in a national or international context. [Subject: Social Work, Healthcare Studies, Public Policy]

The nations of the EU have long led the world in universal health coverage. Recent economic developments have created problems ranging from inequities of care to growing numbers of uninsured — a progression analyzed by Win de Gooijer in Trends in EU Health Care Systems. His ideas may be startling, and the book is bound to be controversial. This is critical reading for health care managers and policymakers, politicians and insurors - anyone looking to Europe to understand this far-reaching evolution.