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Regional OutlookSouthern Europe

The Southern Europe regional outlook presents a comparative assessment of the historical development of the healthcare system, health politics, and selected health-related indicators for Cyprus, Greece, Italy, Portugal, and Spain. The politics of democratic consolidation has influenced the development of healthcare systems; in some periods, healthcare policies have been central to the institutional consolidation and legitimation of existing regimes, but they have also been negatively affected by the political, administrative, and financial shortcomings of these governments. All of these countries have witnessed late transitions from social insurance healthcare systems based on occupation (with fairly developed means-tested programs) to universal and mostly tax-financed national health services: Italy and Portugal made this shift in the 1970s, Spain and Greece in the 1980s, and Cyprus after 2000. As the chapter argues, the central issue in Southern Europe concerns expanding healthcare access in the context of economic vulnerability. According to indicators such as infant mortality, life expectancy, and declines in treatable mortality, health outcomes in Southern Europe are largely favorable, but austerity politics have taken their toll.