Abstrakt
The paper deals with changes in professional status of physicians in the US and Europe which is affected by reforms of the health care system with special attention paid to Europeanization. Marketization of the originally public health care sector in Europe leads in the outcomes to some similarities with the US health care, on the other hand the entire context of the health care system as well as the moral and cultural preconditions still remain principally different.
Marketization in European health care usually leads to quasi-markets or internal markets, whereas Europeanization broadened the playground and provided for additional context for the processes which were already initiated earlier and were justified by the crisis of public budgets and shifts in moral values. Marketization of health care leads to strict economic cost control which may reduce the clinical and corporate autonomy of physicians.
The same effect (i.e. decline in professional autonomy) does regulation have which is introduced within the market-based or even the state-run system. In summary, whenever economic criteria influence too strictly clinical decisions or become prior to them, physicians' autonomy as general is afflicted.
However, the crucial significance of medical education and professional requirements which remain under exclusive medical control still holds the control at least over the professional component of the clinical practice in the medical hands