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Economic Crisis, Health Systems and Health in Europe

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Economic Crisis, Health Systems and Health in Europe Economic crisis…Europe fin.qxp_Layout 1 26/06/2015 08:28 Page 1 Economic Crisis, Health Systems European Observatory on Health Systems and Policies Series and Health in Europe Impact and implications for policy Economic shocks pose a threat to health and health system E c performance by increasing people’s need for health care and o n making access to care more difficult – a situation compounded o by cuts in public spending on health and other social services. m i But these negative effects can be avoided by timely public c policy action. While important public policy levers lie outside C a r n the health sector, in the hands of those responsible for fiscal i s d policy and social protection, the health system response is i s Economic Crisis, H , critical. e H a This book looks at how health systems in Europe reacted to e l a t h pressure created by the financial and economic crisis that began l t Health Systems and h in 2008. Drawing on the experience of over 45 countries, the i n S authors: E y u s t analyse health system responses to the crisis in three policy r Health in Europe e • o m areas: public funding for the health system; health coverage; p e and health service planning, purchasing and delivery s Impact and implications for policy • assess the impact of these responses on health systems and population health M T h l o identify policies most likely to sustain the performance of a d • m health systems facing financial pressure o s v o s n k , y explore the political economy of implementing reforms in a , • F i M crisis g u a e r e The book is essential reading for anyone who wants to r a s s s o understand the choices available to policy-makers – and the , , E C implications of failing to protect health and health-system v y e l t u performance – in the face of economic and other forms of shock. o s v , i K t s a , r Sarah Thomson WHO Regional Office for Europe and the a J o London School of Economics and Political Science. Josep n i w k Sarah Thomson o Figueras European Observatory on Health Systems and Policies. e l t o t s Tamás Evetovits WHO Regional Office for Europe. Matthew , , Josep Figueras Jowett WHO (Geneva). Philipa Mladovsky European K l u Observatory on Health Systems and Policies and the London g Tamás Evetovits e School of Economics and Political Science. Anna Maresso Matthew Jowett European Observatory on Health Systems and Policies. Jonathan Cylus European Observatory on Health Systems and Policies. Philipa Mladovsky Marina Karanikolos European Observatory on Health Systems and Policies. Hans Kluge WHO Regional Office for Europe. Anna Maresso Jonathan Cylus Marina Karanikolos Hans Kluge Economic Crisis, Health Systems and Health in Europe Impact and implications for policy The European Observatory on Health Systems and Policies supports and promotes evid ence- based health policymaking through comprehens ive and rigor ous analysis of health systems in Europe. It brings together a wide range of policymakers, academics and practi tion ers to analyse trends in health reform, drawing on exper i ence from across Europe to illu min ate policy issues. The European Observatory on Health Systems and Policies is a partner ship between the World Health Organization Regional Office for Europe, the Governments of Austria, Belgium, Finland, Ireland, Norway, Slovenia, Sweden, the United Kingdom, and the Veneto Region of Italy, the European Commission, the World Bank, UNCAM (French National Union of Health Insurance Funds), the London School of Economics and Political Science, and the London School of Hygiene & Tropical Medicine. Economic Crisis, Health Systems and Health in Europe Impact and implications for policy Written by Sarah Thomson, Josep Figueras, Tamás Evetovits, Matthew Jowett, Philipa Mladovsky, Anna Maresso, Jonathan Cylus, Marina Karanikolos, Hans Kluge 0 Open University Press Open University Press McGraw- Hill Education McGraw- Hill House Shoppenhangers Road Maidenhead Berkshire England SL6 2QL email: enquir [email protected] world wide web: www.openup.co.uk and Two Penn Plaza, New York, NY 10121- 2289, USA First published 2015 Copyright © World Health Organization 2015 (acting as the host organiz a tion for, and secret ariat of, the European Observatory on Health Systems and Policies). The views expressed by authors or editors do not necessar ily repres ent the decisions or the stated policies of the European Observatory on Health Systems and Policies or any of its partners. The desig na tions employed and the present a tion of the mater ial in this public a tion do not imply the expres sion of any opinion what so ever on the part of the European Observatory on Health Systems and Policies or any of its part ners concern ing the legal status of any country, territ ory, city or area or of its author it ies, or concern ing the delim it a tions of its fron ti ers or bound ar ies. Where the desig na tion ‘country or area’ appears in the head ings of tables, it covers coun tries, territ or ies, cities, or areas. Dotted lines on maps repres ent approx im ate border lines for which there may not yet be full agree ment. The mention of specific compan ies or of certain manu fac tur ers’ products does not imply that they are endorsed or recom men ded by the European Observatory on Health Systems and Policies in pref er ence to others of a similar nature that are not mentioned. Errors and omissions excep ted, the names of propri et ary products are distin guished by initial capital letters. The European Observatory on Health Systems and Policies does not warrant that the informa tion contained in this public a tion is complete and correct and shall not be liable for any damages incurred as a result of its use. The opin ions expressed and argu ments employed herein do not neces sar ily reflect the offi cial views of the OECD or of the govern ments of its member coun tries. Rights to trans late into German, Spanish, French and Russian should be sought from WHO at WHO Regional Office for Europe, Marmorvej 51 DK- 2100 Copenhagen, Denmark or by email at trans la tion [email protected]. Rights to trans late into all other world languages should be sought from Open University Press. All rights reserved. Except for the quota tion of short passages for the purpose of criti cism and review, no part of this public a tion may be repro duced, stored in a retrieval system, or trans mit ted, in any form or by any means, elec tronic, mech an ical, photo copy ing, record ing or other wise, without the prior written permis sion of the publisher or a licence from the Copyright Licensing Agency Limited. Details of such licences (for repro graphic repro duc tion) may be obtained from the Copyright Licensing Agency Ltd of Saffron House, 6–10 Kirby Street, London EC1N 8TS. A cata logue record of this book is avail able from the British Library ISBN- 13: 978- 0- 335- 26400- 1 ISBN- 10: 0- 335- 26400- X eISBN: 978- 0- 335- 26401- 8 Library of Congress Cataloging- in- Publication Data CIP data applied for Typeset by RefineCatch Limited, Bungay, Suffolk Fictitious names of compan ies, products, people, char ac ters and/or data that may be used herein (in case studies or in examples) are not inten ded to repres ent any real indi vidual, company, product or event. European Observatory on Health Systems and Policies Series The European Observatory on Health Systems and Policies is a unique project that builds on the commit ment of all its part ners to improv ing health systems: • World Health Organization Regional Office for Europe • Government of Austria • Government of Belgium • Government of Finland • Government of Ireland • Government of Norway • Government of Slovenia • Government of Sweden • Government of the United Kingdom • Veneto Region of Italy • European Commission • World Bank • UNCAM • London School of Economics and Political Science • London School of Hygiene & Tropical Medicine The Series The volumes in this series focus on key issues for health poli cy mak ing in Europe. Each study explores the conceptual back ground, outcomes and lessons learned about the develop ment of more equit able, more effi cient and more effective health systems in Europe. With this focus, the series seeks to contrib ute to the evol u tion of a more evid ence- based approach to policy formu la tion in the health sector. These studies will be import ant to all those involved in formu lat ing or eval u at ing national health policies and, in partic u lar, will be of use to health poli cy makers and advisers, who are under increas ing pres sure to ration al ize the struc ture and funding of their health system. Academics and students in the field of health policy will also find this series valuable in seeking to better under stand the complex choices that confront the health systems of Europe. The Observatory supports and promotes evid ence- based health poli cy mak ing through compre hens ive and rigor ous analysis of the dynam ics of health care systems in Europe. Series Editors Josep Figueras is the Director of the European Observatory on Health Systems and Policies, and Head of the European Centre for Health Policy, World Health Organization Regional Office for Europe. Martin McKee is Director of Research Policy and Head of the London Hub of the European Observatory on Health Systems and Policies.
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