The Converging Role of the State in OECD Healthcare Systems

Abstract

Healthcare systems can be characterized by the ways they fulfil three basic functions: financing, service provision and regulation, which can be conceptualized as the dimensions of a healthcare system. Part I of this book presented concepts for the systematic description of healthcare systems and the role of the state in healthcare according to these dimensions. Three modalities have been distinguished: a state, a societal and a private form of financing, service provision and regulation. In Part II of this book an account on the changing role of the state in financing and service provision based on 23 OECD countries over four decades was given. Changes were analyzed with respect to general trends but also with respect to the developing differences among states. In Part III, case studies for England, Germany and the US provided more detailed analyses of financing, service provision and, especially, the regulation dimension. As discussed in Chapter 2, these cases have been systematically selected in order to represent three healthcare system types: the National Health Service (NHS), the social insurance system, and the private healthcare system.