Abstract
The health care systems in Austria, Germany and Switzerland owe theirinstitutional structure to different historical developments. While Austriaand Germany voted for the Bismarck-Model of social health insurance,Switzerland adopted a voluntary system of health insurance. In all threecountries, until very recently, the different challenges which the healthcare sector faced were met by piecemeal approaches and by stop and gopolicies, which, in the long run were not very successful either incontaining costs or in improving efficacy and efficiency. During the 1990 morefundamental reforms in the health care systems of all three countries tookplace. Germany and Switzerland chose the path of deregulation of thehealth insurance system, which consequently strengthened the competitionbetween the insurance companies, and, to some extent between thesuppliers of medical services. While this can be seen as an essential part ofthe reform process for these two countries, Austria favors a state-orientedand interventionist approach in order to meet the challenges.
Similar content being viewed by others
References
Badelt, Chr. et al. (1997) Analyse der Auswirkungen des Pflegevorsorgesystems. Wien: Bundesministerium für Arbeit, Gesundheit und Soziales.
Badelt, Chr. et al. (1996) Kosten der Pflegesicherung. Wien: Böhlau-Verlag.
Barr, N. (1990) Economic Theory and the Welfare State: A Survey and Reinterpretation, Discussion Paper No. 54. London: School of Economics and Political Science, London.
Beirat für Wirtschafts-und Sozialfragen (1996) Neue Wege im Gesundheitssystem. Wien: Beirat für Wirtschafts-und Sozialfragen.
Cassel, D. and Janßen, J. (1998) GKV-Wettbewerb ohne Risikostrukturausgleich? Paper presented at the Jahrestagung des Ausschusses für Gesundheitsökonomie im Verein für Scoialpolitik' (Preliminary version).
Gäfgen, G. (1989) Gesundheit, Gerechtigkeit und Gleichheit: Distributive Aspekte der Gesundheitsversorgung. In G. Gäfgen and P. Oberender (Eds.), Verteilungsziele und Verteilungswirkungen im Gesundheitswesen (pp. 11–46). Baden-Baden: Nomos-Verlag.
Knappe, E. (1998) Die Auswirkungen des Wettbewerbs in der Gesetzlichen Krankenversicherung Deutschlands: Eine Zwischenbilanz. In E. Theurl and J. Dezsy (Eds.), Reformen im Gesundheitswesen - Eine Zwischenbilanz (pp. 63–82). Innsbruck: Universität Innsbruck.
Lercher, J. R. (1998) Die Leistungsorientierte Krankenanstaltenfinanzierung (LKF) - eine Analyse der Anreizwirkungen unter besonderer Berücksichtigung der psychiatrischen Krankenversorgung. Innsbruck, unpublished thesis.
Maarse, H. et al. (1998) Health-Insurance Reforms in the Netherlands, Belgium and Germany. In R. Leidl (Ed.), Health Care and its Financing in the Single European Market (pp. 230–253). Amsterdam et al.: IOS Press.
McKinsey Global Institute (1996) Health Care Productivity. Los Angeles: McKinsey Global Institute.
Moser, M. (1998) Das neue Krankenversicherungssystem in der Schweiz - Erste Erfahrungen. In E. Theurl and J. Dezsy (Eds.), Reformen im Gesundheitswesen - Eine Zwischenbilanz (pp. 29–42). Innsbruck: Universität Innsbruck.
OECD (1992) The Reform of Health Care - A Comparative Analysis of Seven OECD Countries. Paris: OECD.
OECD (1998) OECD Health Data 98. Paris: OECD.
OECD (1999) A Caring World - the New Social Policy Agenda. Paris: OECD.
OECD (1998) OECD Economic Surveys 1996 - 1997, Austria. Paris: OECD.
Sommer, J.H. (1997) Managed Care - Erste Erfahrungen in der Schweiz. In E. Knappe (Ed.), 'Manged Care' (pp. 35–45). Baden-Baden: Nomos-Verlag.
Seitz, R. et al. (1998) Managed Care - An Option for the German Health Care System? London: Office of Health Economics.
Stillfried, D., Graf von (1996) Gesundheitssysteme im Wandel. Bayreuth: Verlag P.C.O.
Theurl, E. (1998) Reformen im Gesundheitswesen - ein Ñberblick. In E. Theurl and J. Dezsy (Eds.), Reformen im Gesundheitswesen - Eine Zwischenbilanz (pp. 1–28). Innsbruck: Universität Innsbruck.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Theurl, E. Some Aspects of the Reform of the Health Care Systems in Austria, Germany and Switzerland. Health Care Analysis 7, 331–354 (1999). https://doi.org/10.1023/A:1009426731833
Issue Date:
DOI: https://doi.org/10.1023/A:1009426731833