Health Care Policy and Reform in Germany and Sweden in the 1990s

The provision of welfare is a defining characteristic of the states in Europe, as well as the target of various reform efforts. Within the European welfare states, health care is embedded as a public affair and despite slight variations, the majority of European states guarantees most of the cost of using health services to almost all of their citizens (OECD 1992; 1994). As health care is among the most personal issues, it is also among the most politically discussed. During the 1990s, reforms were introduced in the health care sector in many European countries with the common goal to make existing health care systems more cost efficient and gain greater control over how public resources were spent within them (Mossialos/Le Grand 1999). However, expenditure cuts with regard to the health care system are politically delicate.