The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

Detalhes bibliográficos
Autor(a) principal: Lígia Giovanella
Data de Publicação: 2014
Outros Autores: Klaus Stegmüller
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643
Resumo: The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.
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spelling The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and SpainCrise financeira europeia e sistemas de saúde: universalidade ameaçada? Tendências das reformas de saúde na Alemanha, Reino Unido e EspanhaUniversal Access to Health Care ServicesHealth Care ReformHealth PolicyAcesso Universal a Serviços de SaúdeReforma dos Serviços de SaúdePolítica de SaúdeThe paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.El artículo analiza las tendencias de reformas de salud contemporáneas -dentro del contexto de la crisis económica (2008)- en países europeos con sistemas universales de salud (modelos bismarckiano y beveridgiano) y discute las implicaciones para la universalidad. Se analizan las reformas de salud en España, Alemania y Reino Unido. Para la descripción de los sistemas de salud se utiliza una matriz comparativa de la intervención del Estado en la financiación, regulación, organización y prestación de servicios. Se examinan los efectos de las reformas sobre la universalidad en base a tres dimensiones: amplitud de la cobertura a la población; composición de la cesta de servicios; y nivel de cobertura con fondos públicos. La diversidad de modelos de protección en salud, instituciones implicadas, constelaciones de actores y la posición de esos países en la economía europea han condicionado el impacto de las políticas restrictivas en cada uno de ellos. Estas últimas afectaron a la universalidad en sus tres dimensiones, con diferente intensidad, y profundizaron políticas anteriores de competencia regulada y comercialización.O artigo analisa tendências de reformas de saúde contemporâneas, em contexto de forte pressão financeira, resultante da crise econômica iniciada em 2008, em países europeus com sistemas nacionais de saúde (modelos bismarckiano e beveridgiano) e discute suas consequências para a universalidade. São analisadas reformas recentes na Espanha, Alemanha e Inglaterra. Para descrição dos sistemas de saúde, utiliza-se matriz comparativa da intervenção estatal no financiamento, regulação, organização e prestação de serviços. O exame das repercussões das reformas sobre a universalidade é realizado com base em três dimensões: amplitude da cobertura populacional; abrangência da cesta de serviços; nível de cobertura por financiamento público. Modelos de proteção em saúde, institucionalidade, constelação de atores e posição na economia europeia diferenciados condicionaram as repercussões das políticas restritivas. Elas afetaram a universalidade nas três dimensões, com distinta intensidade nos países, e aprofundaram políticas prévias de competição regulada e comercialização.Reports in Public HealthCadernos de Saúde Pública2014-11-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643Reports in Public Health; Vol. 30 No. 11 (2014): NovemberCadernos de Saúde Pública; v. 30 n. 11 (2014): Novembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643/11723https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643/11724https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643/11725https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643/11726Lígia GiovanellaKlaus Stegmüllerinfo:eu-repo/semantics/openAccess2024-03-06T15:28:50Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/5643Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:06:27.711974Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain
Crise financeira europeia e sistemas de saúde: universalidade ameaçada? Tendências das reformas de saúde na Alemanha, Reino Unido e Espanha
title The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain
spellingShingle The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain
Lígia Giovanella
Universal Access to Health Care Services
Health Care Reform
Health Policy
Acesso Universal a Serviços de Saúde
Reforma dos Serviços de Saúde
Política de Saúde
title_short The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain
title_full The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain
title_fullStr The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain
title_full_unstemmed The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain
title_sort The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain
author Lígia Giovanella
author_facet Lígia Giovanella
Klaus Stegmüller
author_role author
author2 Klaus Stegmüller
author2_role author
dc.contributor.author.fl_str_mv Lígia Giovanella
Klaus Stegmüller
dc.subject.por.fl_str_mv Universal Access to Health Care Services
Health Care Reform
Health Policy
Acesso Universal a Serviços de Saúde
Reforma dos Serviços de Saúde
Política de Saúde
topic Universal Access to Health Care Services
Health Care Reform
Health Policy
Acesso Universal a Serviços de Saúde
Reforma dos Serviços de Saúde
Política de Saúde
description The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.
publishDate 2014
dc.date.none.fl_str_mv 2014-11-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643
url https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643
dc.language.iso.fl_str_mv eng
por
language eng
por
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643/11723
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643/11724
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/5643/11725
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dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.format.none.fl_str_mv text/html
text/html
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 30 No. 11 (2014): November
Cadernos de Saúde Pública; v. 30 n. 11 (2014): Novembro
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
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instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
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