Healthcare reforms and cost reduction strategies in Europe: the cases of Germany, UK, Switzerland, Italy and France.

PURPOSE: This paper aims to analyse health reforms carried out in a sample of European countries. DESIGN/METHODOLOGY/APPROACH: Using a country-specific approach, outstanding health reform features such as: greater competition between sickness funds in Germany; fund-holding practices in the UK; managed care models in Switzerland; health networks in France; and healthcare system decentralisation in Italy are analysed. FINDING: There have been different approaches to controlling healthcare costs. Some states relied on public sector competition by creating quasi-markets (UK), insurance sector competition, particularly in Switzerland and Germany, organisational reforms in France by creating health networks and decentralisation in Italy. RESEARCH LIMITATIONS/IMPLICATIONS: Societal and legal aspects are not discussed. ORIGINALITY/VALUE: The paper compares healthcare reform effectiveness in a number of western European countries.