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The Welfare State in EuropeEconomic and Social Perspectives$
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Pierre Pestieau and Mathieu Lefebvre

Print publication date: 2018

Print ISBN-13: 9780198817055

Published to Oxford Scholarship Online: September 2018

DOI: 10.1093/oso/9780198817055.001.0001

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Health Care

Health Care

(p.137) 11 Health Care
The Welfare State in Europe

Pierre Pestieau

Mathieu Lefebvre

Oxford University Press

This chapter reviews the public health care systems as well as their challenges. It first shows how expenditure on health care has evolved in previous decades and deals with the reasons for the growth observed in almost every European country. It emphasizes the role of technological progress as a main explanatory factor of the increase in medical expenditure but also points to the challenges facing cost-containment policies. Especially, the main common features of health care systems in Europe, such as third-party payment, single provider approach and cost-based reimbursement are discussed. Finally the chapter shows that although inequalities in health exist in the population, health care systems are redistributive. Reforms are thus needed but the trade-off between budgetary efficiency and equity is difficult.

Keywords:   copayment, cost-based reimbursement, Health Maintenance Organization, managed competition, QUALYS, single provider, third-party payment

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