Will managed care work in Europe?

This paper examines major trends in healthcare reforms in the European Union Member States during the last decade. It focuses on managed care developments and shows that, to a certain extent, managed care in Europe is moving towards a consensus. The paper analyses major trends observed across the European Union including the establishment of overall budgets for health services, separation of purchasers from providers, competition between providers, capitation payments for doctors, budget controls on pharmaceutical expenditure and priority-setting methodologies. It then discusses the potential introduction of new forms of managed care and the current weaknesses in information needs and systems. Finally, the policy-makers' dilemmas for resource allocation are examined and a frame-work for policy debate is suggested.