Régulation des systèmes de santé : quelques expériences étrangères de réformes en Europe

Abstract

Improving the health care system : some European reforms In Europe, since nineties, most countries have been engaged in important reforms to improve their health care system and to control costs. These reforms followed a common inspiration and are mainly articulated around : the introduction of market or quasi market mechanisms between Health insurance Funds (Dekker Reform in Netherlands, Seehofer reform in Germany) and/or providers (Thatcher reform in UK) ; a purchaser/provider split in the introduction of new public management methods inspired by the private sector (Nordic and southern European countries) ; the reinforcement of decentralisation (Nordic and southern European countries). Finally, the rolling back of the State in the financing of health care leads to a more important role of private insurers and could bring about changes in the role and nature of both public and private interventions within the whole health care system. JEL classification : H51, I11, O52