Ensuring that levels of public funding for health care are adequate, public revenue flows are predictable and revenue is raised in a way that does not unfairly burden households is essential to safeguarding equitable access to needed health services. In many countries the national health budget was reduced as a result of the crisis due to deliberate adjustments, rises in unemployment or a combination of the two (Mladovsky et al. 2012) Countries are likely to find it difficult to cope with budget shortfalls if demand for publicly financed health care is rising, entitlement to publicly financed health care is means tested and incomes are falling, automatic stabilisers are absent and public spending as a share of total spending on health care is low.

Publications

Aloumanis K, Kapetanos G, Bartzis N, Drossinos V; Hellenic ExFOS study group. Teriparatide use during an economic crisis: baseline data from the Greek cohort of the Extended Forsteo Observational Study (ExFOS). BMC MusculoskeletDisord. 2015 Jun 5;16:136

Anderson I, Axelson H, Tan BK. The other crisis: the economics and financing of maternal, newborn and child health in Asia. Health Policy Plan. 2011 Jul;26(4):288-97.

Atun R, Knaul FM, Akachi Y, Frenk J. Innovative financing for health: what is truly innovative? Lancet. 2012 Dec 8;380(9858):2044-9.

Bacigalupe A, Martín U, Font R, González-Rábago Y, Bergantiños N. [Austerityand healthcare privatization in times of crisis: are there any differences among autonomous communities?]. Gac Sanit. 2016 Jan-Feb;30(1):47-51

Bacigalupe A, Martí­n U, Font R, González-Rábago Y, Bergantiños N. [Differences in austerity and healthcare privatisation between autonomous communities in times of crisis in Spain. Replay]. Gac Sanit. 2016 Apr 23. [Epub ahead of print] Spanish.  No abstract available.

Barros PP. Health policy reform in tough times: the case of Portugal. Health Policy. 2012 Jun;106(1):17-22.

Bennett D. The Bottom line medicine. recession is forcing physicians to concentrate more on finances. Med Econ. 2009 Dec 18;86(24):22-4.

Budhdeo S, Watkins J, Atun R, Williams C, Zeltner T, Maruthappu M. Changes in government spending on healthcare and population mortality in the European union, 1995-2010: a cross-sectional ecological study. J R Soc Med. 2015 Oct 28. [Epub ahead of print] 

Capital allocation challenges facing boards grow as financial crisis deepens. Expert Rev Pharmacoecon Outcomes Res. 2013 Dec 2. [Epub ahead of print]. 

Catania JA, Dolcini MM, Gandelman AA, Narayanan V, McKay VR. Fiscal loss and program fidelity: impact of the economic downturn on HIV/STI prevention program fidelity. Transl Behav Med. 2014 Mar;4(1):34-45. 

Chen J, Vargas-Bustamante A, Mortensen K, Thomas SB. Using Quantile Regression to Examine Health Care Expenditures during the Great Recession. Health Serv Res. 2013 Oct 18. [Epub ahead of print] 

Combe CG. Impact of the financial crisis on health research financing: towards a new model? Expert Rev Pharmacoecon Outcomes Res. 2009 Aug;9(4):321-4.

de Belvis AG, Ferrè F, Specchia ML, Valerio L, Fattore G, Ricciardi W. he financial crisis in Italy: implications for the healthcare sector. Health Policy. 2012 Jun;106(1):10-6. 

Dervenis C, Kastanioti C, Polyzos N. Restructuring the finances of the greek health care system in the era of economic crisis. World J Surg. 2013 Mar;37(3):707-9. 

Erwin PC, Shah GH, Mays GP. Local health departments and the 2008 recession: characteristics of resiliency. Am J Prev Med. 2014 Jun;46(6):559-68.

Fanourgiakis J, Kanoupakis E. Catastrophic healthcare expenditure during economic recession in the field of cardiovascular disease. Expert Rev Pharmacoecon Outcomes Res. 2013 Dec 2 [Epub ahead of print]

Frischhut M, Fahy N. Patient Mobility in Times of Austerity: A Legal and Policy Analysis of the Petru Case. Eur J Health Law. 2016 Mar;23(1):36-60.

Goranitis I, Siskou O, Liaropoulos L. Health policy making under information constraints: An evaluation of the policy responses to the economic crisis in Greece. Health Policy. 2014 Sep;117(3):279-84.

Greer SL, Jarman H, Baeten R. The New Political Economy of Health Care in the European Union: The Impact of Fiscal Governance. Int J Health Serv. 2016;46(2):262-82.

Grigorakis N, Floros C, Tsangari H, Tsoukatos E. Combined social and private health insurance versus catastrophic out of pocket payments for private hospital care in Greece. Int J Health Econ Manag 2017 Jan 3 [Epub ahread of print].

Helderman JK. The crisis as catalyst for reframing health care policies in the European Union. Health Econ Policy Law. 2015 Jan;10(1):45-59.

Hunter DJ. The impact of the spending review on health and social care. BMJ. 2010 Oct 27;341:c6022. 

Iacobucci G. NHS cash props up private health sector as recession cuts private patients' spending. BMJ. 2013 May 22;346:f3356.

Jacob JA. Greater Health Care Spending May Moderate Recession's Negative Health Effects. JAMA. 2016 Jan 19;315(3):237-9. No abstract available. 

Jooma R, Khan A, Khan AA. Protecting Pakistan's health during the global economic crisis. East Mediterr Health J. 2012 Mar;18(3):287-93.

Keast K. Australia's health cuts. Paying the price for austerity measures. Aust Nurs Midwifery J. 2015 Feb;22(7):20-4. 

Keegan C, Thomas S, Normand C, Portela C. Measuring recession severity and its impact on healthcare expenditure. Int J Health Care Finance Econ. 2013 Jun;13(2):139-55. 

Kelsall D, Hennings C. Austerity and fiscal prudence are health issues. CMAJ. 2015 Aug 31. pii: cmaj.150950. [Epub ahead of print] 

Kirigia JM, Nganda BM, Mwikisa CN, Cardoso B. Effects of global financial crisis on funding for health development in nineteen countries of the WHO African Region. BMC Int Health Hum Rights. 2011 Apr 13;11:4. 

Labonté R, Stuckler D. The rise of neoliberalism: how bad economics imperils health and what to do about it. J Epidemiol Community Health. 2015 Sep 30. [Epub ahead of print]

Lassman D, Hartman M, Washington B, Andrews K, Catlin A. US Health Spending Trends By Age And Gender: Selected Years 2002-10. Health Aff (Millwood). 2014 May;33(5):815-22. 

Leach-Kemon K, Chou DP, Schneider MT, Tardif A, Dieleman JL, Brooks BP, Hanlon M, Murray CJ. The global financial crisis has led to a slowdown in growth of funding to improve health in many developing countries. Health Aff (Millwood). 2012 Jan;31(1):228-35.

Leider JP, Resnick B, Kass N, Sellers K, Young J, Bernet P, Jarris P. Budget- and priority-setting criteria at state health agencies in times of austerity: a mixed-methods study. Am J Public Health. 2014 Jun;104(6):1092-9.

Levit KR, Mark TL, Coffey RM, Frankel S, Santora P, Vandivort-Warren R, Malone K. Federal spending on behavioral health accelerated during recession as individuals lost employer insurance. Health Aff (Millwood). 2013 May;32(5):952-62.

Loughnane C, Murphy A, Mulcahy M, McInerney C, Walshe V. Have bailouts shifted the burden of paying for healthcare from the state onto individuals? Ir J Med Sci. 2018 Apr 9. doi: 10.1007/s11845-018-1798-x. [Epub ahead of print]

Marks L, Weatherly H, Mason A. Prioritizing investment in public health and health equity: what can commissioners do? Public Health. 2013 May;127(5):410-8. doi: 10.1016/j.puhe.2013.01.027. 

Martin A, Lassman D, Whittle L, Catlin A; National Health Expenditure Accounts Team. Recession contributes to slowest annual rate of increase in health spending in five decades. Health Aff (Millwood). 2011 Jan;30(1):11-22.

Martin-Moreno JM, Anttila A, von Karsa L, Alfonso-Sanchez JL, Gorgojo L. Cancer screening and health system resilience: keys to protecting and bolstering preventive services during a financial crisis. Eur J Cancer. 2012 Sep;48(14):2212-8.

Maynard A. Funding health care in times of austerity:what goes around comes around J Health Serv Res Policy. 2013 Jan;18(1):1-2.

McCarthy M. US austerity program cuts are expected to hit non-profit hospital revenues. BMJ. 2013 Apr 11;346:f2311.

McKee M, Basu S, Stuckler D. Health systems, health and wealth: the argument for investment applies now more than ever. Soc Sci Med. 2012 Mar;74(5):684-7.

Mitka M. Recession helped put brakes on growth in US health care spending for 2008. JAMA. 2010 Feb 24;303(8):715.

Mitton C, Dionne F, Donaldson C. Managing Healthcare Budgets in Times of Austerity: The Role of Program Budgeting and Marginal Analysis. Appl Health Econ Health Policy. 2014 Jan 24. [Epub ahead of print]

Mladovsky P, Srivastava D, Cylus J, et al. Policy summary 5. Health policy responses to the financial crisis in Europe. World Health Organization on behalf of the European Observatory on Health Systems and Policies, 2012.

Mladovsky P, Srivastava D, Cylus J, Karanikolos M, Evetovits T, Thomson S, McKee M. Health policy in the financial crisis. Eurohealth, 2012, 18(1):3-6

Morgan D, Astolfi R. Financial impact of the GFC: health care spending across the OECD. Health Econ Policy Law. 2015 Jan;10(1):7-19.

Morris L.The moral economy of austerity: analysing UK welfare reform. Br J Sociol. 2016 Mar;67(1):97-117.

Neagu OM, Michelsen K, Watson J, Dowdeswell B, Brand H. Addressing health inequalities by using Structural Funds. A question of opportunities. Health Policy 2017 Mar;121(3):300-306.

No authors listed. Calling time on the Cancer Drugs Fund? Funding the NHS in the age of austerity. Br J Hosp Med (Lond). 2015 Apr 2;76(4):186-7.

Nuti S, Vainieri M, Frey M. Healthcare resources and expenditure in financial crisis: scenarios and managerial strategies. J Matern Fetal Neonatal Med. 2012 Oct;25 Suppl 4:48-51. Review. 

Olafsdottir AE, Allotey P, Reidpath DD. A health system in economic crises: a case study from Iceland. Scand J Public Health. 2013 Mar;41(2):198-205. Epub 2012 Dec 20. 

Papadopoulos C. Notable numbers--economic recession and health care spending. J Can Dent Assoc. 2009 May;75(4):267-8.

Pellegrini LC, Rodriguez-Monguio R, Qian J. The US healthcare workforce and the labor market effect on healthcare spending and health outcomes. Int J Health Care Finance Econ. 2014 Jun;14(2):127-41.

Petmesidou M, Pavolini E, Guillén AM, South European Healthcare Systems under Harsh Austerity: A Progress-Regression Mix? South European Society and Politics, 2014, 19(3):331-352

Poulsen CA. Introducing out-of-pocket payment for General Practice in Denmark: Feasibility and support. Health Policy. 2014 Apr 26.  [Epub ahead of print]

Radu P, Purcărea V, Popa F. The costs of the economic crisis in the health sector. J Med Life. 2009 Jan-Mar;2(1):1-4.

Rajmil L, Ferná¡ndez de Sanmamed MJ. [Differences between autonomous communities in austerity and healthcare privatization in times of crisis]. Gac Sanit. 2016 Mar 11.. [Epub ahead of print] Spanish.  No abstract available.

Rechel B, Brand H, McKee M. Financing public health in europe. Gesundheitswesen. 2013 May;75(5):e28-33. 

Reeves A, Basu S, McKee M, Marmot M, Stuckler D. Austere or not? UK coalition government budgets and health inequalities. J R Soc Med. 2013 Nov;106(11):432-6.

Reeves A, Basu S, McKee M, Meissner C, Stuckler D. Does investment in the health sector promote or inhibit economic growth? Global Health. 2013 Sep 23;9(1):43.

Reeves A, McKee M, Basu S, Stuckler D. The political economy of austerity and healthcare: Cross-national analysis of expenditure changes in 27 European nations 1995-2011. Health Policy. 2014 Mar;115(1):1-8.

Reschovsky A, Zahner SJ. Forecasting the Revenues of Local Public Health Departments in the Shadows of the "Great Recession". J Public Health Manag Pract. 2013 Mar 25. [Epub ahead of print]

Recession, state budget cuts imperil drug assistance programs. "The waiting lists have started up again". AIDS Alert. 2009 Sep;24(9):97-100. 

Robinson S, Williams I, Dickinson H, Freeman T, Rumbold B. Priority-setting and rationing in healthcare: evidence from the English experience. Soc Sci Med. 2012 Dec;75(12):2386-93.

Ruckert A, Labonté R. The global financial crisis and health equity: Early experiences from Canada. Global Health. 2014 Jan 6;10(1):2. [Epub ahead of print].

Saltman RB. The impact of slow economic growth on health sector reform: a cross-national perspective. Health Econ Policy Law. 2018 Jan 24:1-24. doi: 10.1017/S1744133117000445. [Epub ahead of print]

Sarti S, Terraneo M, Tognetti Bordogna M. Poverty and private health expenditures in Italian households during the recent crisis. Health Policy 2017 March;121(3):307-314.

Schrijvers G. Global payment for health services as a solution in the financial crisis in Europe. Int J Integr Care. 2012 Oct 31;12:e228. Print 2012 Oct.

Siskou O, Kaitelidou D, Economou C, Kostagiolas P, Liaropoulos L. Private expenditure and the role of private health insurance in Greece: status quo and future trends. Eur J Health Econ. 2009 Oct;10(4):467-74. 

Sommers A, Cunningham PJ. Medical bill problems steady for U.S. families, 2007-2010. Track Rep. 2011 Dec;(28):1-5. 

Souliotis K, Golna C, Tountas Y, Siskou O, Kaitelidou D, Liaropoulos L. Informal payments in the Greek health sector amid the financial crisis: old habits die last... Eur J Health Econ. 2015 Feb 3. [Epub ahead of print].

Sussman JB, Halasyamani LK, Davis MM. Hospitals during recession and recovery: vulnerable institutions and quality at risk. J Hosp Med. 2010 May-Jun;5(5):302-5.

Svaljek S. The recent health reform in Croatia: True reforms or just a fundraising exercise? Health Policy 2013 Oct 3 [Epub ahead of print]

Thomas S, Burke S, Barry S. The Irish health-care system and austerity: sharing the pain. Lancet. 2014 May 3;383(9928):1545-6.

Truffer CJ, Keehan S, Smith S, Cylus J, Sisko A, Poisal JA, Lizonitz J, Clemens MK. Health spending projections through 2019: the recession's impact continues. Health Aff (Millwood). 2010 Mar-Apr;29(3):522-9. 

Vargas Bustamante A, Chen J. The Great Recession and Health Spending among Uninsured U.S. Immigrants: Implications for the Affordable Care Act Implementation. Health Serv Res. 2014 Jun 24. [Epub ahead of print]

Voelker R. One casualty of global economic crisis: uncertain finances for HIV/AIDS programs. JAMA. 2010 Jul 21;304(3):259-61.