The choice of healthcare models: How much does politics matter?

Abstract

This article discusses the main hypotheses generated within the strand of research that focuses on health politics. These hypotheses are subjected to a brief empirical test, presenting data from 15 OECD countries. There seems to be a correspondence between the healthcare models adopted in different national contexts and the ideological orientation of the governments that have instituted them. Most laws instituting a system of social health insurance have been advanced by conservative governments, while those instituting a national health service have been passed – in the majority of cases – by social-democratic governments. The resulting clashes between governments and competing interest groups are largely attributable to the institutional setting. Thus, in the period from 1945 to 2000, most of those countries where political power was more concentrated implemented a national health service. Conversely, those countries where political power was more dispersed tended to maintain a system of voluntary or social health insurance.