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Purpose

This paper aims to analyse health reforms carried out in a sample of European countries.

Design/methodology/approach

Using a country‐specific approach, outstanding health reform features such as: greater competition between sickness funds in Germany; fund‐holding practices in the UK; managed care models in Switzerland; health networks in France; and healthcare system decentralisation in Italy are analysed.

Finding

There have been different approaches to controlling healthcare costs. Some states relied on public sector competition by creating quasi‐markets (UK), insurance sector competition, particularly in Switzerland and Germany, organisational reforms in France by creating health networks and decentralisation in Italy.

Research limitations/implications

Societal and legal aspects are not discussed.

Originality/value

The paper compares healthcare reform effectiveness in a number of western European countries.

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