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Health Policy Developments Issue 3: Focus on Accountability, (De)Centralization, Information Technologiesogies

Busse R, Schlette S
Gütersloh: Bertelsmann Foundation Publishers


The third issue of “Health Policy Developments” pays special

attention to five concurrent health policy topics, all of them high

on health policy agendas in a variety of developed countries:

– Accountability and participation

– Coordination of care

– Public health and prevention

– Centralization versus decentralization

– Technical innovations and bioethics

Two of these topics, accountability and prevention, are of particular

interest to the Bertelsmann Stiftung.

Accountability and


As an independent yet not neutral player in the German health

care system, the Foundation examines health care services and

health policy reform from the specific, usually underrepresented

viewpoint of the insured themselves. Much lip service has been

paid to the importance of the informed patient, the patient as the

focus of attention, and the patient’s responsibility to participate in

the maintenance of good health and in the treatment process. In

practice, however, little has changed. Many stakeholders—insurers,

physicians, politicians, and the health care industry—-

claim to know what is best for the patients or so-called health care


Behind these claims often lurk profit interests, professional

self-esteem, or—a variation of profit interests—the politician’s

pursuit of re-election. While this is not the place to challenge the

legitimacy of business or power interests, recent experience has

indeed shown just how important patient views are to policymakers.

In fact, politicians are increasingly sensitive and attentive

to their voters’ concerns about health care.

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