Beveridge, Bismarck and Southern European Health Care Systems: Can We Decide Which is the Best in EU-15? A Statistical Analysis

Abstract

A statistical analysis has been conducted with the aim to elucidate the effect of health care systems (HSs) on health inequalities assessed in terms of (a) differential access to health care services and (b) varying health outcomes among different models of HSs in EU-15 ((Beveridge: UK, IE, SE, FI, DK), (Bismarck: DE, FR, BE, LU, AT, NL), (Southern European model: GR, IT, ES, PT)). In the effort to interpret the results of the empirical analysis, we have ascertained systematic differences among the HSs in EU-15. Specifically, it is concluded that countries with Beveridge HS can be characterized more efficient (than average) in the most examined correlations, showing particularly high performance in the health sector. Similarly, countries with Bismarck HS record fairly satisfactory performance, but simultaneously they display more structural weaknesses compared with the Beveridge model. In addition, our empirical analysis has shown that adopting Bismarck model requires higher economic cost, compared with the Beveridge model, which is directly financed by taxation. On the contrary, in the countries with Southern European HS, the lowest performances are generally identified, which can be attributed to the residual social protection that characterizes these countries. The paper concludes with a synthesis of the empirical findings of our research. It proposes some directions for further research and presents a set of implications for policymakers regarding the planning and implementation of appropriate policies in order to tackle health inequality within HSs.