70126 - Health Systems

Course Unit Page


This teaching activity contributes to the achievement of the Sustainable Development Goals of the UN 2030 Agenda.

Good health and well-being

Academic Year 2019/2020

Learning outcomes

At the end of the course the student is introduced to the principles of health care organization and policy in a comparative perspective. Aim of the course is to understand the evolution and contemporary state of health care systems in different OECD countries. By the end of the course, the student is able to: 1) Identify the key characteristics and components of health care systems. 2) Assess each health care systems strengths and weaknesses 3) Explain the recent health care reform efforts in OECD countries

Course contents

Course contents:

The evolutionary path of European health care systems

Various models of health care funding, including the differences between tax based models, SHI-models and models based on voluntary insurance

Models of health care provision

Health care reforms over the last two decades

Social justice arguments behind the different systems

Full course description is available on IOL (https://iol.unibo.it/)



Blank, R.H. and Burau, V. (2014). Comparative Health Policy, 4th Edition. New York: Palgrave McMillan. Chapters 1, 2, 3 and 5.


Required readings

Hassenteufel P. and B. Palier (2007), Towards Neo-Bismarckian Health Care States? Comparing Health Insurance Reforms in Bismarckian Welfare Systems, in Social Policy & Administration, vol. 41, n. 6, pp. 574-596.

Rothgang H. et al. (2005), The changing role of the state in healthcare systems, in European Review, vol. 13, suppl. 1, pp. 187-212.

Toth F. (2010), Healthcare policies over the last 20 years: Reforms and counter-reforms, in Health Policy, vol. 95, n. 1, pp. 82-89.

Toth, F. (2013),  The choice of healthcare models: How much does politics matter?, in Internaational Political Science Review, vol. 34, n. 2, pp. 159-172.

Toth, F. (2016), Classification of healthcare systems: Can we go further?, in Health Policy, vol. 120, n. 5, pp. 535-543.


Further readings

Gostin L. and Powers M. (2006), What Does Social Justice Require for the Public's Health? Public Health Ethics and Policy Imperatives, in Health Affairs, vol. 24, n.4, pp. 1053-1060.

Jegers, M. et al. (2002), A typology for provider payment systems in health care, in Health Policy, vol. 60, n.3, pp. 255-273

Leibowitz A. and M. Peterson (2009), Perspectives on the U.S. Health Care System, in Rivista Italiana di Politiche Pubbliche, vol. 8, n. 2, pp. 9-41.

Magnussen J., R. Saltman, K. Vrangbaek and P. Martinussen (2009), The Nordic model of health care, in J. Magnussen , K. Vrangbaek and R. Saltman (eds): Nordic health care systems. Recent reforms and current policy challenges, London, Open University Press.

Rothgang H et al. (2010), The State and Healthcare. Comparing OECD Countries, Chippenham, Palgrave Macmillan. Chapters 2, 3 and 4.

Schmid A. et al. (2010), Explaining Health Care System Change: Problem Pressure and the Emergence of "Hybrid" Health Care Systems, in Journal of Health Politics, Policy and Law, vol. 35, n. 4, pp. 455-86.

Van de Ven, W. et al. (2003), Risk adjustment and risk selection on the sickness fund insurance market in five European countries, in Health Policy, vol. 65, 75-89.

Teaching methods

Traditional lectures and class discussion.

The course consists of 10 meetings of 180 minutes each.

Assessment methods

Final assessment will be calculated as follows: attendance and participation in class 20%; final written exam 80%.

The written exam consists of 5 open questions.

As an alternative to the written final exam, students can choose to prepare a “country summary report”. All instructions concerning the preparation of these summary reports will be provided in class.

Teaching tools

Traditional lectures and class discussion. Voluntary student oral presentation.

Office hours

See the website of Federico Toth