University of Salerno, 17-19 September, 2015

Conference website: http://www.espanet-italia.net/conferenza2015.html

SESSION: “Understanding healthcare system change in Europe: Processes of transformation in times of crisis”

COORDINATORS: Franca Maino and Stefano Neri - University of Milan

KEYNOTE SPEAKER: Lorraine Frisina Doetter - University of Bremen


SESSION DESCRIPTION

Since the 1980s, healthcare systems in Europe have been subject to successive waves of reform unfolding within a period of profound demographic changes marked by aging populations, ample influxes of migrants, and new epidemiological trends and prevalence of acute and chronic diseases. At the core of healthcare reforms is an attempt at reconciling the often opposing aims of cost containment and efficiency maximization, on the one hand; and the improvement of quality and reorganization of services in line with changing population needs, on the other. Ultimately, this has translated into structural reforms that rely on managerialism and administrative competition, the decentralization of political and administrative bodies, and the rather restrictive politics of supply and demand.
Thus far, structural reforms have led to a phenomenon of healthcare system hybridizationamongst European countries which, from an institutional standpoint, has nevertheless allowed systems to maintain the core attributes linking them to one of two main system typologies: the social insurance system and National Health Service. In terms of access to services, hybridization has also left intact the basic principle of universalism (whether complete or near to complete) characterizing European healthcare systems. Adding to these historic changes, however, is the role played in more recent years by the economic and financial crises starting in 2008 and the related politics of austerity heavily affecting Mediterranean countries such as Italy. Although it may still be too early to gage the long-term effects of the crises on Southern European healthcare systems, it is possible to hypothesize that certain processes are underway which, in part, advance the reform tendencies observed over the past two decades, while also diverging from them by undermining universalism.
If indeed the demands of cost containment have led to an expansion of the use of managerial instruments in health care, they have also intensified the adoption of the restrictive politics of supply and demand such that access to services by relevant groups of the population is now being called into question. This can especially be seen in the case of Greece. Moreover, despite research on new sources of financing that can secure a return to protected employment, whether integrative or substitutive, developments unfolding in Italy and Spain tell a different story.
A major part of the reform landscape has been defined by the issue of decentralization, particularly in countries where such political tendencies have long been present, as in Spain and Italy, or, in Northern Europe, Denmark, and Norway. Decentralization, which refers to the transferring of substantial powers and responsibilities from the central to lower bodies of government, is argued to increase efficiency, efficacy and innovation in healthcare systems. By bringing policy making closer to citizens, it is also said to allow for greater bottom-up participation in the production of health. In more recent years, however, this thinking has come somewhat to a halt, as re-centralizing at least some policy competencies has been deemed necessary to assure nation-wide standards for services, population health, and cost containment, even within a larger system of decentralization. The politics of austerity related to the recent financial crises have played a special role in recentralization, as central governments are not only being pushed to largely retake direct control of healthcare spending, particularly in countries where sub-national bodies have proven ineffective at cost containment (as in many regions of Italy), but also to redirect the utilization of increasingly scarce resources by way of imposing nationally shared policy objectives.
With these developments in mind, we welcome papers that analyze the impact of the financial crises on European healthcare systems, particularly the potential role and extent to which policy interventions have undermined the institutional assets and direction of policy making defined by earlier decades. Accordingly, relevant papers may reconstruct the principal drivers of reform in recent years, as well as their implications for access to services, quality and financial sustainability. Paper topics may also concern interventions that focus on the redefinition of organizational and institutional assets related to the financing and production of health services, or, those which modify the relations between different levels of assistance, or, that of the public and private; the (re)division of powers between levels of government; or changes and developments in managerialism in the healthcare sector. Papers may deal with single European case studies or involve comparative studies; however, a focus on Mediterranean countries is especially welcome.



CALL for ABSTRACTS: Submit your abstract here: http://www.espanet-italia.net/call-for-paper-2015/send-the-abstract.html

DEADLINE to submit an abstract: May 25th, 2015.

NOTIFICATION: Authors will be notified about the acceptance of their abstracts via email byJune 5th, 2015.

PAPER SUBMISSION by August 24th, 2015. Authors of accepted abstracts will send their full papers to session coordinators (Cc to espanet2015@unisa.it).



CONTACTS:

Franca Maino

Department of Social and Political Studies, University of Milan

Email: franca.maino@unimi.it



Stefano Neri

Department of Social and Political Studies, University of Milan

Email: stefano.neri@unimi.it