Explaining Convergence and Common Trends in the Role of the State in OECD Healthcare Systems

Harvard Health Policy Review, Vol. 9, No. 1, pp. 5-16, Spring 2008

12 Pages Posted: 27 May 2010

See all articles by Mirella I. Cacace

Mirella I. Cacace

RAND Europe; University of Bremen

Ralf Götze

University of Bremen - Centre for Social Policy Research (CeS)

Achim Schmid

University of Bremen - CRC 597

Heinz Rothgang

University of Bremen - Centre for Social Policy Research (CeS)

Date Written: 2008

Abstract

This paper seeks to explain a convergence trend in the role of the state in OECD healthcare systems. By convergence we mean that healthcare systems become increasingly similar with regards to the public/private mix in financing and service provision, and with respect to their regulatory structure. In particular, we identify increasing similarities between the three system types we delineate as National Health Service, Social Health Insurance and Private Health Insurance systems. We argue that the specific healthcare system type is an essential explanatory factor. Systems tend to feature specific, type-related deficiencies, which cannot be solved by routine mechanisms. As a consequence, non system-specific elements and innovative policies are implemented which lead to the emergence of ‘hybrid’ systems indicating a trend towards convergence.

Keywords: comparative analysis, convergence, change, explanation, public/private mix, healthcare system type

JEL Classification: I11, I18, N40, P17, H51

Suggested Citation

Cacace, Mirella I. and Götze, Ralf and Schmid, Achim and Rothgang, Heinz, Explaining Convergence and Common Trends in the Role of the State in OECD Healthcare Systems (2008). Harvard Health Policy Review, Vol. 9, No. 1, pp. 5-16, Spring 2008, Available at SSRN: https://ssrn.com/abstract=1616591

Mirella I. Cacace (Contact Author)

RAND Europe ( email )

Westbrook Centre
Milton Road
Cambridge, Cambridge CB4 1YG
United Kingdom

University of Bremen ( email )

Universitaetsallee GW I
Bremen, D-28334
Germany

Ralf Götze

University of Bremen - Centre for Social Policy Research (CeS) ( email )

Bremen
Germany

HOME PAGE: http://zes-bremen.de

Achim Schmid

University of Bremen - CRC 597 ( email )

Linzer Str. 9a
Bremen, D-28359
Germany
+49 (0) 421 218-56631 (Phone)

HOME PAGE: http://www.sfb597.uni-bremen.de/homepages/schmid/index.php

Heinz Rothgang

University of Bremen - Centre for Social Policy Research (CeS) ( email )

Bremen
Germany

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