Political Economy of Health Care Financing

The paper aims at the correspondence of the health care financing systems to the social models (welfare regimes) as defined in the social theory and policy, including the trends in the OECD and CEE countries and utilizing the lessons from typical countries. We compare the liberal, social-democratic, conservative and neo-liberal models of health care financing, mentioning the Communist model and the single-payer system as well. The National Health Service model may also today be considered as a viable, social-democratic model of the basic health protection. The social health insurance model was markedly modified by the transition to the universal health care provision to all residents and there are strengthening tendencies to the split-off of the health insurance from the social insurance system; the result might be a transition to the NHS model or, on the contrary, to the neo-liberal mandatory private insurance system. The choice of the health care financing is a question a political, economic and social choice and the particular solution is not seldom also substantially influenced by the stakeholders. That is why there are also substantial deviations of the paradigmatic reforms from the corresponding theoretical models.

Keywords: health insurance, health care, National Health Service, health reform, welfare regime