Health Expenditure in the European Economy

International audienceHealth expenditure is a particularly sensitive political issue for European Union countries. This is due to the continuing increase in expenditure, the considerable state spending devoted to this field and the questions that are raised on the effectiveness of this state spending. However, going beyond these general factors, there are significant disparities between the situations in the various countries. These reveal differences in the quality of the services provided and costs of these services. These differences may help to understand not only certain disparities in the economic attraction of the countries but also the geographical mobility of patients seeking healthcare. To explain the background in which European health systems operate, this report gives a few introductory remarks on the methodological choices, followed by an overall view of the situation regarding healthcare expenditure, indicating the current trends. The next section comments on the quality of the results obtained given the reimbursement rates provided for the public and the health situation as it stands. Finally, the report comments on the regulatory mechanisms that have been adopted to ensure better use of resources

In between the market and public health insurance: a place for occupational welfare in Europe?

International audienceThere is a growing body of studies emphasising the multi-pillar configuration of protection against social risk in Europe, particularly in pension reform. In this chapter, we try to expand on this literature to find applicability beyond the sole case of pensions by looking at the case of occupational health insurance in France. In order to do so, we present a restatement of the pillar/provision perspective in order to apply it to a broader range of cases. We argue it is a powerful analytical tool provided it is complemented with a (non-exhaustive) list of perspectives widely used in studies on social policy and does not blunder into the pitfall of functionalism. The chapter focuses on crossing the pillar perspective with a finance and also a regime perspective. Following the seminal intuition of R. Titmuss, an important result yielded is that the overall structure of resources distribution of the whole welfare system can become highly anti-redistributive once occupational schemes and fiscal incentives are included in the analysis