Special Issue on Innovations in Health Care System Reform in OECD Countries

Health care systems can be seen as a house, with financing and service provision as two pillars resting on a foundation of shared values, perceptions and guiding principles. The roof would then represent the regulation of the interactions between service providers, financing agencies, and potential beneficiaries such as patients (Rothgang et al., 2010: 11). Health care systems in the Organization for Economic Cooperation and Development (OECD) countries seem to be in a state of permanent change, i.e. they seem to continuously strive to adjust to economic, political, and social demands. Indeed, the economic recession that followed the oil price shocks of the 1970s marked the end of the Golden Age of the welfare state and triggered a range of cost containment measures in OECD countries that have continued over four decades up to the present. Currently, the OECD health care systems have to deal with a new phase of economic turmoil brought on by the most recent financial crisis (Starke, 2007). According to Rothgang and colleagues (2010), this doesn’t mean that OECD countries have had an easy time curtailing public financing and implementing reduced welfare policies. This observation is particularly meaningful for the health care sector because its legitimacy relies on its ability to provide a satisfactory standard of health care for all citizens, regardless of their ability to pay for care.