<p>During the last 20 years, privatization<br />became an issue in health care. The neoliberal<br />market idea promised to increase<br />efficiency and responsiveness, while at the<br />same time relieving public budgets. European<br />countries have introduced all kind of market<br />instruments, reaching from internal markets,<br />over DRGs, to increased co-payments.<br />However, the welfare state literature<br />currently lacks a detailed explanation of<br />these different reforms.<br />All health care systems in the European<br />Union are affected by the same problem<br />pattern: demographic change, raising<br />demand, medical-technical innovations and<br />labour intensive services. Nonetheless, the<br />degree and form of privatization varies a lot.<br />This paper studies the power of ideas within<br />the framework of structural reform pressure<br />and institutional path-dependency. The<br />causes for privatization reforms are studied<br />in two countries representing the two ideal<br />types: the Netherlands for Social Health<br />Insurance and Sweden for the National<br />Health Service.</p>