A Mediterranean paradigm? Convergence and divergence in Southern Europe

Author: Guido Giarelli
Submitted: Friday 4th of November 2011 01:01:18 PM
Submitted by: egf
Educational levels: expert, qc2, qc3


In a seminal article published in 1994, the authors wondered whether the health care systems of Southern Europe could be grouped under the label of a ‘Mediterranean paradigm’: they answered positively by arguing that the health care systems of Italy, Greece and Spain had a series of features in common such as a specific pattern of health and disease, a common historical evolution of their national health services, based on shared principles, only partial implementation, and similar problems of organization, delivery and mismanagement. After reconsidering such features in contrast with the characteristics of the other three main European health regions (Northern, Central-Western and Central-Eastern Regions), we shall try to deepen the argument by examining the internal differences of the Euro-mediterranean health systems (including Portugal) to assess convergence and divergence in actual reforms and future trends. In this way, a sharp contrast emerges between Italy and Spain on one side – which share a process of de-centralization of their health care systems – and Portugal and Greece on the other side, where the implementation process of their respective national health services is very partial and incomplete. Therefore, it is incorrect to speak of a ‘Mediterranean paradigm’ as a unitary and common system, unless we draw some significant distinctions within it.


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Guido Giarelli. A Mediterranean paradigm? Convergence and divergence in Southern Europe. EUROGENE portal. November 2011. online: http://eurogene.open.ac.uk/content/mediterranean-paradigm-convergence-and-divergence-southern-europe-0

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