Skip to main content
SpringerLink
Log in

The Healthcare Sector

  • Chapter
  • First Online:
Trajectories of Governance

Part of the book series: International Series on Public Policy ((ISPP))

Abstract

This chapter examines governance change in health policy in the six case countries. The analysis intends to reconstruct the healthcare governance methods implemented in these countries and understand how they have evolved over the last 30 years. While each case study nation has faced similar pressures on health governance and has to some extent each introduced a similar reform agenda, national institutions, traditions and ideas have strongly shaped the trajectory of governance change. If we compare the policy mixes used in the 1980s and those used more recently, two common trends can be seen in all the countries here analysed. The first trend is the use, to a greater extent, of informational tools, which were rarer in the 1980s. The second trend of policy-makers is to compose policy mixes using a greater number of policy tools; in most cases, policy mixes are composed of a variety of regulatory and financial tools, both soft and hard.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Alders, P., & Schut, F. T. (2019). The 2015 long-term care reform in the Netherlands: Getting the financial incentives right? Health Policy, 123(3), 312–316.

    Article  Google Scholar 

  • Altenstetter, C. (1997). Health policy-making in Germany: Stability and dynamics. In C. Altenstetter & J. W. Björkman (Eds.), Health policy reform. National variations and globalization (pp. 136–161). Macmillan.

    Chapter  Google Scholar 

  • Bevan, G. (2014). The impacts of asymmetric devolution on health care in the four countries of the UK. Health Foundation.

    Google Scholar 

  • Bevan, G., & Robinson, R. (2005). The interplay between economic and political logics: Path dependency in health care in England. Journal of Health Politics, Policy and Law, 30(1–2), 53–78.

    Article  Google Scholar 

  • Blümel, M., Spranger, A., Achstetter, K., Maresso, A., & Busse, R. (2020). Germany: Health system review. Health Systems in Transition, 22(6), 1–273.

    Google Scholar 

  • Busse, R., Blümel, M., Knieps, F., & Bärnighausen, T. (2017). Statutory health insurance in Germany: A health system shaped by 135 year of solidarity, self-governance, and competition. Lancet, 390, 882–897.

    Article  Google Scholar 

  • Connelly, L. B., Paolucci, F., Butler, J., & Collins, P. (2010). Risk equalisation and voluntary health insurance markets: The case of Australia. Health Policy, 98(1), 3–14.

    Article  Google Scholar 

  • Cylus, J., Richardson, E., Findley, L., Longley, M., O’Neill, C., & Steel, D. (2015). United Kingdom: Health system review. Health Systems in Transition, 17(5), 1–125.

    Google Scholar 

  • de Belvis, A. G., Ferrè, F., Specchia, M. L., Valerio, L., Fattore, G., & Ricciardi, W. (2012). The financial crisis in Italy: Implications for the healthcare sector. Health Policy, 106(1), 10–16.

    Article  Google Scholar 

  • Duckett, S. (2018). Expanding the breadth of Medicare: Learning from Australia. Health Economics, Policy and Law, 13(3–4, 344), –368.

    Google Scholar 

  • Enthoven, A. C. (1985). Reflections on the management of the National Health Service. Nuffield Provincial Hospital Trust.

    Google Scholar 

  • Evans, R. G. (2000). Canada. Journal of Health Politics, Policy and Law, 25(5), 889–897.

    Article  Google Scholar 

  • Fierlbeck, K. (2011). Health care in Canada. University of Toronto Press.

    Google Scholar 

  • Flood, C. M., & Haugan, A. (2010). Is Canada odd? A comparison of European and Canadian approaches to choice and regulation of the public/private divide in health care. Health Economics, Policy and Law, 5(3), 319–341.

    Article  Google Scholar 

  • France, G., & Taroni, F. (2005). The evolution of health-policy making in Italy. Journal of Health Politics, Policy and Law, 30(1–2), 169–187.

    Article  Google Scholar 

  • Geva-May, I., & Maslove, A. (2000). What prompts health care policy change? On political power contest and reform of health care systems (the case of Canada and Israel). Journal of Health Politics, Policy and Law, 25(4), 717–741.

    Article  Google Scholar 

  • Giaimo, S. (2016). Reforming health care in the United States, Germany, and South Africa. Palgrave Macmillan.

    Book  Google Scholar 

  • Gray, G. (1998). Access to medical care under strain: New pressures in Canada and Australia. Journal of Health Politics, Policy and Law, 23(6), 905–947.

    Article  Google Scholar 

  • Greß, S., Groenewegen, P., Kerssens, J., Braun, B., & Wasem, J. (2002). Free choice of sickness funds in regulated competition: Evidence from Germany and The Netherlands. Health Policy, 60(3), 235–254.

    Article  Google Scholar 

  • Hall, J. (1999). Incremental change in the Australian health care system. Health Affairs, 18(3), 95–110.

    Article  Google Scholar 

  • Hall, J. (2010). Health-care reform in Australia: Advancing or side-stepping? Health Economics, 19(11), 1259–1263.

    Article  Google Scholar 

  • Ham, C. (2009). Health policy in Britain. The politics and organisation of the National Health Service (6th ed.). Palgrave Macmillan.

    Google Scholar 

  • Ham, C., Baird, B., Gregory, S., Jabbal, J., & Alderwick, H. (2015). The NHS under the coalition government. Part 1: NHS reform. The King’s Fund.

    Google Scholar 

  • Helderman, J. K., Bevan, G., & France, G. (2012). The rise of the regulatory state in health care: A comparative analysis of the Netherlands, England and Italy. Health Economics, Policy and Law, 7(1), 103–124.

    Article  Google Scholar 

  • Huntington, S. (1991). The third wave. Democratization in the late twentieth century. University of Oklahoma Press.

    Google Scholar 

  • Hurst, J. W. (1991). Reforming health care in seven European nations. Health Affairs, 10(3), 7–21.

    Article  Google Scholar 

  • Jacobs, A. (1998). Seeing difference: Market health reforms in Europe. Journal of Health Politics, Policy and Law, 23(1), 1–33.

    Article  Google Scholar 

  • Karanikolos, M., Mladovsky, P., Cylus, J., Thomson, S., Basu, S., Stuckler, D., Mackenbach, J., & McKee, M. (2013). Financial crisis, austerity, and health in Europe. The Lancet, 381, 1323–1331.

    Article  Google Scholar 

  • Kentikelenis, A. (2015). Bailouts, austerity and the erosion of health coverage in Southern Europe and Ireland. European Journal of Public Health, 25(3), 365–366.

    Article  Google Scholar 

  • Kifmann, M. (2017). Competition policy for health care provision in Germany. Health Policy, 121(2), 119–125.

    Article  Google Scholar 

  • Klein, R. (1998). Why Britain is reorganizing its National Health Service—Yet again. Health Affairs, 17(4), 115–126.

    Article  Google Scholar 

  • Klein, R. (2013). The new politics of the NHS (7th ed.).

    Google Scholar 

  • Kroneman, M., Boerma, W., van den Berg, M., Groenewegen, P., de Jong, J., & van Ginneken, E. (2016). The Netherlands: Health system review. Health Systems in Transition, 18(2), 1–239.

    Google Scholar 

  • Kutzin, J. (2001). A descriptive framework for country-level analysis of health care financing arrangements. Health Policy, 56(3), 171–204.

    Article  Google Scholar 

  • Lehto, J., Vrangbaek, K., & Winblad, U. (2015). The reactions to macro-economic crises in Nordic health system policies: Denmark, Finland and Sweden, 1980-2013. Health Economics, Policy and Law, 10(1), 61–81.

    Article  Google Scholar 

  • Maarse, H., Jeurissen, P., & Ruwaard, D. (2016). Results of the market-oriented reform in the Netherlands: A review. Health Economics, Policy and Law, 11(2), 161–178.

    Article  Google Scholar 

  • Marchildon, G. P. (2019). Health system in Canada. In A. Levy, S. Goring, C. Gatsonis, B. Sobolev, E. van Ginneken, & R. Busse (Eds.), Health services evaluation (pp. 769–777). Springer.

    Chapter  Google Scholar 

  • Marchildon, G. P., Allin, S., & Merkur, S. (2020). Canada: Health system review. Health Systems in Transition, 22(3), 1–194.

    Google Scholar 

  • Mossialos, E., & Dixon, A. (2002). Funding health care: An introduction. In E. Mossialos, A. Dixon, J. Figueras, & J. Kutzin (Eds.), Funding health care: Options for Europe (pp. 59–79). Open University Press.

    Google Scholar 

  • OECD. (2002). OECD health data 2002. A comparative analysis of 30 countries. OECD.

    Google Scholar 

  • Okma, K., & Crivelli, L. (2013). Swiss and Dutch “consumer-driven health care”: Ideal model or reality? Health Policy, 109(2), 105–112.

    Article  Google Scholar 

  • Oliver, A. (2005). The English National Health Service: 1979-2005. Health Economics, 14(S1), 75–99.

    Article  Google Scholar 

  • Palladino, R., Lee, J. T., Hone, T., Filippidis, F., & Millett, C. (2016). The great recession and increased cost sharing in European health systems. Health Affairs, 35(7), 1204–1213.

    Article  Google Scholar 

  • Reeves, A., McKee, M., & Stuckler, D. (2015). The attack on universal health coverage in Europe: Recession, austerity and unmet needs. European Journal of Public Health, 25(3), 364–365.

    Article  Google Scholar 

  • Rothgang, H., Cacace, M., Grimmeisen, S., & Wendt, C. (2005). The changing role of the state in healthcare systems. European Review, 13(S1), 187–212.

    Article  Google Scholar 

  • Saltman, R. B., & Figueras, J. (1998). Analyzing the evidence on European health care reforms. Health Affairs, 17(2), 85–108.

    Article  Google Scholar 

  • Schut, F., & Varkevisser, M. (2017). Competition policy for health care provision in the Netherlands. Health Policy, 121(2), 126–133.

    Article  Google Scholar 

  • Streeck, W., & Thelen, K. (2005). Introduction: Institutional change in advanced political economies. In W. Streeck & K. Thelen (Eds.), Beyond continuity: Institutional change in advanced political economies (pp. 1–39). Oxford University Press.

    Google Scholar 

  • Thomson, S., Figueras, J., Evetovits, T., Jowett, M., Mladovsky, P., Maresso, A., Cylus, J., Karanikolos, M., & Kluge, H. (2014). Economic crisis, health systems and health in Europe: Impact and implications for policy. WHO Regional Office for Europe.

    Google Scholar 

  • Toth, F. (2010). Healthcare policies over the last 20 years: Reforms and counter-reforms. Health Policy, 95(1), 82–89.

    Article  Google Scholar 

  • Toth, F. (2014). How health care regionalization in Italy is widening the north-south gap. Health Economics Policy and Law, 9(3), 231–249.

    Article  Google Scholar 

  • Toth, F. (2015). Like surfers waiting for the big wave: Health care politics in Italy. Journal of Health Politics, Policy and Law, 40(5), 1001–1021.

    Article  Google Scholar 

  • Toth, F. (2016a). The Italian NHS, the public/private sector mix and the disparities in access to healthcare. Global Social Welfare, 3(3), 171–178.

    Article  Google Scholar 

  • Toth, F. (2016b). Classification of healthcare systems: Can we go further? Health Policy, 120(5), 535–543.

    Article  Google Scholar 

  • Toth, F. (2019). Prevalence and generosity of health insurance coverage: A comparison of EU member states. Journal of Comparative Policy Analysis: Research and Practice, 21(5), 518–534.

    Google Scholar 

  • Toth, F. (2020). Integration vs separation in the provision of health care: 24 OECD countries compared. Health Economics, Policy and Law, 15(2), 160–172.

    Article  Google Scholar 

  • Toth, F. (2021a). Comparative health systems. A new framework. Cambridge University Press.

    Book  Google Scholar 

  • Toth, F. (2021b). How policy tools evolve in the healthcare sector. Five countries compared. Policy Studies, 42(3), 232–251.

    Article  Google Scholar 

  • van de Ven, W. (1996). Market-oriented health care reforms: Trends and future options. Social Science & Medicine, 43(5), 655–666.

    Article  Google Scholar 

  • Vonk, R., & Schut, F. (2019). Can universal access be achieved in a voluntary private health insurance market? Dutch private insurers caught between competing logics. Health Economics, Policy and Law, 14(3), 315–336.

    Article  Google Scholar 

  • Willcox, S. (2001). Promoting private health insurance in Australia. Health Affairs, 20(3), 152–161.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Political & Social Sciences, University of Bologna, Bologna, Italy

    Giliberto Capano

  2. Department of Politics, Newcastle University, Newcastle Upon Tyne, UK

    Anthony R. Zito

  3. Political and Social Sciences, University of Bologna, Bologna, Italy

    Federico Toth

  4. School of Public Policy, University of Saskatchewan, Saskatoon, SK, Canada

    Jeremy Rayner

Authors
  1. Giliberto Capano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony R. Zito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Federico Toth
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jeremy Rayner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giliberto Capano .

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Capano, G., Zito, A.R., Toth, F., Rayner, J. (2022). The Healthcare Sector. In: Trajectories of Governance. International Series on Public Policy . Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-031-07457-8_4

Download citation

Publish with us

Policies and ethics

Search

Navigation