This is the first book to examine the processes of territorial federalization and decentralization of health systems in Europe drawing from an interdisciplinary economics, public policy and political science approach. It contains key theoretical and empirical features that allow an understanding of when health care decentralization is successful.

Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.

While health system decentralization is often associated with federations, there has been limited study on the connection between federalism and the organization of publicly financed or mandated health services. Federalism and Decentralization in Health Care examines eight federations that differ in terms of their geography, history and constitutional and political development. Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines constitutional responsibility for health care, the national laws establishing a right to health care, the predominant sources and organization of public revenues directed to health care, and the overall organization of the health system. In additional to these structural features, each country case study is subjected to a "decision space analysis" to determine the actual degree of health system decentralization. This involves determining whether national and subnational governments have narrow, moderate or broad discretion in their decisions on governance, access, human resources, health system organization and financing. This comparative approach highlights the similarities and differences among these federations. Offering reflections on recent trends in centralization or decentralizations for the health system as a whole, Federalism and Decentralization in Health Care, is a valuable resource for those studying health care policy in federal systems and especially those interested in comparative aspects of the topic.

How does fiscal decentralisation affect the development of a health system? Evidence from health care decentralisation in Europe can offer some insights to the question above. This paper addresses the effects of health care decentralisation in Europe, and reviews some of the key questions on the design of a health system. We argue that contrary to old mobility argument, the effects of health care decentralisation result from tighter political agency, which generally stands as an alternative to health care privatisation. However, whether efficiency improves after a process of decentralisation depends heavily on the incentives fiscal design exerts on cost -containment, inter-jurisdictional competition, policy innovation and diffusion. Experiences of health care decentralisation highlight important concerns associated with vertical imbalances and limited horizontal imbalances. Finally, health care decentralisation can give rise to a new regional political cycle where citizens can reward or penalise the performance of health policy.

This comprehensive scholarly book on comparative federalism and the Covid-19 pandemic is written by some of the world’s leading federal scholars and national experts. The Covid-19 pandemic presented an unprecedented emergency for countries worldwide, including all those with a federal or hybrid-federal system of government, which account for more than 40 per cent of the world’s population. With case studies from 19 federal countries, this book explores the core elements of federalism that came to the fore in combatting the pandemic: the division of responsibilities (disaster management, health care, social welfare, and education), the need for centralisation, and intergovernmental relations and cooperation. As the pandemic struck federal countries at roughly the same time, it provided a unique opportunity for comparative research on the question of how the various federal systems responded. The authors adopt a multidisciplinary approach to question whether federalism has been a help or a hindrance in tackling the pandemic. The value of the book lies in understanding how the Covid-19 pandemic affected federal dynamics and how it may have changed them, as well as providing useful lessons for how to combat such pandemics in federal countries in the future. This book will be of great interest to students and scholars of politics and international relations, comparative federalism, health care, and disaster management. The Open Access version of this book, available at http://www.taylorfrancis.com, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.

·What are the characteristics that define a Social Health Insurance system? ·How is success measured in SHI systems? ·How are SHI systems developing in response to external pressures? Using the seven Social Health Insurance countries in western Europe - Austria, Belgium, France, Germany, Luxembourg, the Netherlands and Switzerland - as well as Israel, this important book reviews core structural and organizational dimensions, as well as recent reforms and innovations. Covering a wide range of policy issues, the book: ·Explores the pressures these health systems confront to be more efficient, more effective, and more responsive ·Reviews their success in addressing these pressures ·Examines the implications of change on the structure of SHI’s as they are currently defined ·Draws out policy lessons about past experience and likely future developments in SHI systems in a manner useful to policymakers in Europe and elsewhere Social Health Insurance Systems in Western Europe will be of interest to students of health policy and management as well as health managers and policy-makers. Contributors: Helmut Brand, Jan Bultman, Reinhard Busse, Laurent Chambaud, David Chinitz, Diana M.J. Delnoij, André P. den Exter, Aad A. de Roo, Anna Dixon, Isabelle Durand-Zaleski, Hans F.W. Dubois, Josep Figueras, Bernhard Gibis, Stefan Greß, Bernhard J. Güntert, Jean Hermesse, Maria M. Hofmarcher, Martin McKee, Pedro W. Koch-Wulkan, Claude Le Pen, Kieke G.H. Okma, Martin Pfaff, Richard B. Saltman, Wendy G.M. van der Kraan, Jürgen Wasem, Manfred Wildner, Matthias Wismar.