Dalhousie Law Journal


Europe, health care, reform, managed competition


Most countries in Europe are at various stages in the process of reforming their health care systems. Instead of different and more diverse systems emerging, the health reform process has resulted in a convergence on "managed competition" as the only acceptable means for delivering health care. After briefly describing the historical context, this paper examines the nature and scope of the reform process in Europe. The major features of the reforms are cost-containment and a reduction in the role of the state. There have been few systematic attempts to measure the extent to which expectations are being realized. The paper concludes with an assessment of the likely effects of "reforms"on the health care map of Europe.