Health Care System Retrenchment
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2016-05
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en
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Recent studies have argued that European welfare states have been under tremendous pressure since the onset of the recent Global Financial Crisis (GFC). The health sector, in particular, has been affected by retrenchment politics aimed at reducing public spending. Cross-national variation, however, is clearly observed as the policy responses have manifested themselves unevenly across the landscape of welfare states. This thesis is the first to examine the relationship between welfare state retrenchment, health care systems and the GFC. Using crisp-set qualitative comparative analysis (csQCA), the study intends to identify patterns of welfare state retrenchment in health care system trajectories of European countries during the (aftermath of the) recent financial crisis. The results suggest that for the occurrence of health care system retrenchment various factors in different combinations are important. Three sufficient paths towards retrenchment are observed: 1) the presence of right-oriented governments combined with being a non-liberal market economy; 2) the absence of obfuscation tactics combined with being a liberal market economy; and 3) the presence of obfuscation tactics along with lower economic growth rates and EU-pressure. Further analysis was revealed to examine why certain countries cluster around a particular pathway. We suppose that these patterns can be explained by looking at the incentives for political action. The conclusion drawn is that three particular logics could be observed: retrenchment as a window of opportunity, retrenchment as a market-function approach and retrenchment as a spillover effect. Although the findings only permit for modest generalization and further work needs to be done, the results do reveal that health care system retrenchment a topic worthy of further investigation
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Faculteit der Managementwetenschappen