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Health reform monitor — The impact of the financial crisis (Editorial).
|Verlag||Health Policy 106(1):
As part of their activities, the partners of the Health Systems and Policy Monitor will from now onwards report regularly on reforms in their countries – be they just proposed and debated, be the legislative process ongoing, or be they in the process of implementation. These reports will carry the heading “Health Reform Monitor”, and the first four from Italy, Portugal and Spain can be found in this issue. The focus of the reports is on the impact of the financial crisis on health systems, an issue which was already the focus of the final Health Policy Developments book in 2009. At that time, governments still had very different answers to the financial crisis – besides cutting expenditure as in Estonia, others – e.g. in Germany or the United States – were putting in additional money for health care and/or health care-related research to soften the impact of the crisis on employment.
Meanwhile, the range of solutions has been narrowed down – at least in the countries severely affected by the crisis in southern Europe as reported in this issue: Cutting public expenditure by reducing salaries, pharmaceutical reimbursement, excluding certain benefits from the benefit package, increasing co-payments, reducing or abolishing cost-sharing exemptions etc. seem to be the only solutions, partly due to direct pressure of international lending institutions , but partly also self-imposed. The opportunity to use the crisis to introduce reforms in order to systematically increase efficiency and quality through guidelines, Health Technology Assessment or new reimbursement mechanisms is, somewhat surprisingly, missed – or at the most left to the regions in response to cope with national