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The rise of the regulatory state in health care: a comparative analysis of the Netherlands, England and Italy

Helderman, Jan-Kees, Bevan, Gwyn and France, George (2012) The rise of the regulatory state in health care: a comparative analysis of the Netherlands, England and Italy. Health Economics, Policy and Law, 7 (01). pp. 103-124. ISSN 1744-1331

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Abstract

In a relatively short time, regulation has become a significant and distinct feature of how modern states wish to govern and steer their economy and society. Whereas the former dirigiste state used to be closely related to public ownership (e.g. hospitals), planning (volume and capacity planning) and centralised administration (e.g. fixed prices and budgets), the new regulatory state relies mainly on the instrument of regulation to achieve its objectives. In this paper, we wish to relate the rise of the regulatory state to the path-dependent trajectories and institutional legacies of discrete European health-care systems. For this purpose, we compared the Dutch corporatist social health insurance system, the strongly centralised National Health Service (NHS) of England and federal regionalised NHS system of Italy. Comparing these three different health-care systems suggests that it is indeed possible to identify a general trend towards the rise of the regulatory state in health care in the last two decades. However, although the three countries examined in this paper face similar problems of multilevel governance of networks of third-party payers and providers, each system also gives rise to its own distinct regulatory challenges.

Item Type: Article
Official URL: http://journals.cambridge.org/action/displayJourna...
Additional Information: © 2012 Cambridge University Press.
Library of Congress subject classification: R Medicine > RA Public aspects of medicine
Sets: Departments > Management
Research centres and groups > Centre for Analysis of Risk and Regulation (CARR)
Research centres and groups > LSE Health
Rights: http://www.lse.ac.uk/library/usingTheLibrary/academicSupport/OA/depositYourResearch.aspx
Date Deposited: 23 Feb 2012 15:33
URL: http://eprints.lse.ac.uk/41977/

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