Hospital Care: Private Assets for-a-Profit?
The context for health and hospital care will continue to change greatly. One area of change is ownership, between public, public-private partnership, private not-for-profit, and private for-profit. There are differences between formal and effective control, given that almost everywhere the state has a major role. Pseudo-markets can be created by a purchaser-provider split. Measurable performance differences between the various types is often ambiguous. Perhaps surprisingly, public hospitals are as efficient as private ones, but responsiveness is less. There should be different governance constraints to recognize the different types of provider. Guaranteeing universal access will require care in terms of contractability and accountability considerations, and bailout possibilities.
KeywordsAccountability Bailout Contractability Effective control Efficient Formal control For-profit Governance Not-for-profit Ownership Private Pseudo-markets Public Public-private partnership Purchaser-provider split Responsiveness Universal access
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