Health care is a central pillar of the welfare state, in fact, the second pillar in terms of expenditure after pensions. However, we know little about how they perform. European health care systems have been put increasingly under pressure during the last two decades. They have had to face a quadrilemma: to control costs and the increase in public expenditure; to guarantee equality of access; to maximize the quality of care; and to guarantee the responsiveness of the health system and the satisfaction of patients and professionals working in the field. Achieving good results on all these four objectives is extremely difficult and often trade-offs arise among different objectives. Using in-depth case study analysis on eight health care systems, belonging to different Welfare State traditions, and comparative statistical analysis on a broader group of countries, the book connects the main policy reforms of the last two decades with how well these systems perform, in terms of economic efficiency, medical achievements, social inequalities, and patients' and workers' conditions.