Leitura indispensável

Health Economics, special issue: Analysing the Impact of Health System Changes in the EU Member States (link)

Payment to hospitals, successive governments have been unable to control costs and there have been several factors that might help us to understand this phenomenon. For example, there were expenditure pressures due to the cost of human resources, rigidities making it difficult to shift funding away from the hospital sector, a growth in subsystem expenditure funded by the government, increases in the pharmaceutical budget, and the non-accountability of providers and managers.
Incentives designed to alter providers’ behaviour were limited in both their scope and coverage. There have been only minor improvements in efficiency, due to institutional inertia and the lack of incentives for altering stakeholders’ behaviour (providers and consumers.

In Health care reform in Portugal: an evaluation of the NHS experience , Mónica Duarte Oliveira, Carlos Gouveia Pinto (link)