Abstract
The economic recession following the oil price shocks of the 1970s triggered a broad range of cost containment measures in social polices throughout the OECD world. Health care was no exception. Globalization, demographic change and advancements in medical technology have strengthened the need for reforms that assure both the quality and efficiency of health-care systems while at the same time guaranteeing equal access to services (OECD, 1994). The pertinent question to be dealt with in this contribution is how the role of the state and the market in attaining these challenging and somewhat contradictory objectives, has changed over time. Evidence suggests that although common challenges are experienced, the responses to various socio-economic pressures have differed considerably across healthcare systems (Tuohy, 1999; Rothgang et al., 2006). Starting in the 1990s, for example, we observe that in many predominately publicly financed health-care systems market-oriented health-care reforms have been implemented or proposed (van de Ven, 1996; Freeman and Schmid, forthcoming), whereas in countries with private insurance systems access to health care and the introduction of universal health insurance have gained political salience (Skocpol, 1994; Zweifel, 2000). This contribution focuses particularly on the ‘hybridization’ of health-care systems induced by the changing public–private mix. In order to capture these developments systematically, we differentiate between dimensions of health-care systems: financing, service provision and regulation.
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© 2008 Heinz Rothgang, Mirella Cacace, Lorraine Frisina and Achim Schmid
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Rothgang, H., Cacace, M., Frisina, L., Schmid, A. (2008). The Changing Public-Private Mix in OECD Health-care Systems. In: Seeleib-Kaiser, M. (eds) Welfare State Transformations. Palgrave Macmillan, London. https://doi.org/10.1057/9780230227392_8
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DOI: https://doi.org/10.1057/9780230227392_8
Publisher Name: Palgrave Macmillan, London
Print ISBN: 978-1-349-30214-7
Online ISBN: 978-0-230-22739-2
eBook Packages: Palgrave Social & Cultural Studies CollectionSocial Sciences (R0)