Some Aspects of the Reform of the Health Care Systems in Austria, Germany and Switzerland

The health care systems in Austria, Germany and Switzerland owe theirinstitutional structure to different historical developments. While Austriaand Germany voted for the Bismarck-Model of social health insurance,Switzerland adopted a voluntary system of health insurance. In all threecountries, until very recently, the different challenges which the healthcare sector faced were met by piecemeal approaches and by stop and gopolicies, which, in the long run were not very successful either incontaining costs or in improving efficacy and efficiency. During the 1990 morefundamental reforms in the health care systems of all three countries tookplace. Germany and Switzerland chose the path of deregulation of thehealth insurance system, which consequently strengthened the competitionbetween the insurance companies, and, to some extent between thesuppliers of medical services. While this can be seen as an essential part ofthe reform process for these two countries, Austria favors a state-orientedand interventionist approach in order to meet the challenges.