Social Health Insurance Systems in Western Europe

by Saltman, Richard; Busse, Reinhard; Figueras, Josep

• ISBN13: 9780335213634
• ISBN10: 0335213634
• Edition: 1st
• Format: Paperback
• Copyright: 2004-09-01
• Publisher: Open University Press

Summary

·What are the characteristics that define a Social Health Insurance system?·How is success measured in SHI systems?·How are SHI systems developing in response to external pressures?Using the seven Social Health Insurance countries in western Europe - Austria, Belgium, France, Germany, Luxembourg, the Netherlands and Switzerland - as well as Israel, this important book reviews core structural and organizational dimensions, as well as recent reforms and innovations.Covering a wide range of policy issues, the book:·Explores the pressures these health systems confront to be more efficient, more effective, and more responsive·Reviews their success in addressing these pressures·Examines the implications of change on the structure of SHI's as they are currently defined·Draws out policy lessons about past experience and likely future developments in SHI systems in a manner useful to policymakers in Europe and elsewhereSocial Health Insurance Systems in Western Europe will be of interest to students of health policy and management as well as health managers and policy-makers.Contributors: Helmut Brand, Jan Bultman, Reinhard Busse, Laurent Chambaud, David Chinitz, Diana M.J. Delnoij, André P. den Exter, Aad A. de Roo, Anna Dixon, Isabelle Durand-Zaleski, Hans F.W. Dubois, Josep Figueras, Bernhard Gibis, Stefan Greß, Bernhard J. Güntert, Jean Hermesse, Maria M. Hofmarcher, Martin McKee, Pedro W. Koch-Wulkan, Claude Le Pen, Kieke G.H. Okma, Martin Pfaff, Richard B. Saltman, Wendy G.M. van der Kraan, Jürgen Wasem, Manfred Wildner, Matthias Wismar.

Table of Contents

List of contributors	vii
Introduction	x
Foreword	xii
Acknowledgements	xiv
Part One	1	(298)
Social health insurance in perspective: the challenge of sustaining stability	3	(18)
Richard B. Saltman
The historical and social base of social health insurance systems	21	(12)
Richard B. Saltman
Hans F.W. Dubois
Organization and financing of social health insurance systems: current status and recent policy developments	33	(48)
Reinhard Busse
Richard B. Saltman
Hans F.W. Dubois
Patterns and performance in social health insurance systems	81	(60)
Josep Figueras
Richard B. Saltman
Reinhard Busse
Hans F.W. Dubois
Assessing social health insurance systems: present and future policy issues	141	(14)
Richard B. Saltman
Part Two
The challenge to solidarity	153	(2)
Governance and (self-)regulation in social health insurance systems	155	(15)
David Chinitz
Matthias Wismar
Claude Le Pen
Solidarity and competition in social health insurance countries	170	(19)
Anna Dixon
Martin Pfaff
Jean Hermesse
Key organizational issues	187	(2)
Shifting criteria for benefit decisions in social health insurance systems	189	(18)
Bernhard Gibis
Pedro W. Koch-Wulkan
Jan Bultman
Contracting and paying providers in social health insurance systems	207	(20)
Maria M. Hofmarcher
Isabelle Durand-Zaleski
The role of private health insurance in social health insurance countries	227	(21)
Jurgen Wasem
Stefan Greß
Kieke G.H. Okma
The changing role of the individual in social health insurance systems	248	(19)
Manfred Wildner
Andre P. den Exter
Wendy G.M. van der Kraan
Beyond acute care	265	(2)
Prevention and public health in social health insurance systems	267	(14)
Martin McKee
Diana M.J. Delnoij
Helmut Brand
Long-term care in social health insurance systems	281	(18)
Aad A. de Roo
Laurent Chambaud
Bernhard J. Guntert
Index	299