© 2013

Federalism and Decentralization in European Health and Social Care

  • Joan Costa-Font
  • Scott L. Greer

Table of contents

  1. Front Matter
    Pages i-xiii
  2. Health System Federalism and Decentralization

  3. Background

    1. Front Matter
      Pages 11-11
  4. Cross-Country Evidence in Tax-Funded Health Systems

  5. Cross-Country Evidence in Social Insurance Systems

    1. Front Matter
      Pages 121-121
    2. Katarzyna A. Kuć-Czajkowska, Małgorzata Rabczewska
      Pages 123-153
    3. Birgit Trukeschitz, Ulrike Schneider, Thomas Czypionka
      Pages 154-189
    4. Berit C. Gerritzen, Gebhard Kirchgässner
      Pages 250-271
    5. Joan Costa-Font, Scott L. Greer
      Pages 272-276
  6. Back Matter
    Pages 277-278

About this book


This is the first book to examine the processes of territorial federalization and decentralization of health systems in Europe drawing from an interdisciplinary economics, public policy and political science approach. It contains key theoretical and empirical features that allow an understanding of when health care decentralization is successful.


budget federalism health policy nationalism Policy political science

Editors and affiliations

  • Joan Costa-Font
    • 1
  • Scott L. Greer
    • 2
  1. 1.London School of Economics and Political ScienceUnited Kingdom
  2. 2.Department of Health Management and PolicyUniversity of MichiganUSA

About the editors

JOAN COSTA FONT is Reader in Political Economy and stream convener MPA Social and public policy at the LSE
SCOTT L. GREER is an Associated Professor at the University of Michigan, USA.

Bibliographic information


A very welcome contribution testing the impact of health care decentralisation on health policies, accountability and citizens' satisfaction. This book makes clear that political infra-state devolution not only promotes and encourages emulation between jurisdictions but that also, in the absence of fiscal responsibility in these states, impacts negatively on the public budgets of the countries examined.

-Guillem López-Casasnovas, Professor of Economics, Pompeu Fabra University, Barcelona, Spain

The pathbreaking chapters in this book are precise when existing accounts are vague, lucid when other accounts are confusing, and politically savvy throughout. The book is a major contribution to the comparative understanding of health, policy, and territorial politics in Europe

-Guy Lodge, Institute for Public Policy Research and Nuffield College, University of Oxford, UK