Improving Efficiency and Containing Costs: Health Care Reform in Southern Europe.

The paper constitutes the first detailed comparative study of Southern health care systems. It begins by analysing the reforms they underwent during the seventies and eighties, that is, the introduction of national health services in Italy, Portugal, Greece, and Spain. The second section of the paper assesses the measures adopted by Southern health care systems in order to contain the cost of health care services in the nineties. The third section considers the impact of the two reform waves on the macroinstitutional framework of Soutthern health care systems, as compared to those of other European Union members. Finally, the main factors accouting for reform trajectories are singled out and the "Southern model of welfare" is discussed in what regards health care.