IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Log in (now much improved!) to save this paper

On the Fuzzy Boundaries between Public and Private in Health Care Organization and Funding Systems

Abstract

The paper proposes a survey of health care organization and funding systems in order to underline and discuss, in this specific field of social assistance, the combination public versus private provision and production of services. The survey then examines the present features of various National health services focusing on the efficiency and equity of public intervention and on the industrial organization of the institutional design of health care. In this context, it treats the rationale of cost-benefit of vertical integration of structures, devoted respectively to purchasing and providing health care services. Further, the paper considers the advantages and disadvantages of managed competition in quasi-markets and, finally, it deals with insurance systems, social as well private and supplementary ones. From the survey it turns out that the main distinctions of health care regimes in industrialised countries are not in terms of private versus public ownership of providers, rather in terms of industrial organization setting and in terms of the proportion of public versus private expenditure.

Download Info

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL: http://www.disei.unifi.it/upload/sub/pubblicazioni/repec/pdf/wp09_2010.pdf
Download Restriction: no

Paper provided by Universita' degli Studi di Firenze, Dipartimento di Scienze per l'Economia e l'Impresa in its series Working Papers - Economics with number wp2010_09.rdf.

as
in new window

Length: 34 pages
Date of creation: 2010
Date of revision:
Handle: RePEc:frz:wpaper:wp2010_09.rdf
Contact details of provider: Postal:
Via delle Pandette 9 50127 - Firenze - Italy

Phone: +39 055 2759582
Fax: +39-055-2759550
Web page: http://www.disei.unifi.it/
Email:


More information through EDIRC

Keywords: Health care organization; health care funding; social insurance; private and public provision.;

Other versions of this item:

Find related papers by JEL classification:
  • I1 - Health, Education, and Welfare - - Health
  • H1 - Public Economics - - Structure and Scope of Government
  • H4 - Public Economics - - Publicly Provided Goods

This paper has been announced in the following NEP Reports:

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. BOADWAY, Robin & MARCHAND, Maurice & SATO, Motohiro, . "An optimal contract approach to hospital financing," CORE Discussion Papers RP 1692, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  2. Ching-to Albert Ma, 1994. "Health Care Payment Systems: Cost and Quality Incentives," Papers 0047, Boston University - Industry Studies Programme.
  3. Chalkley, Martin & Khalil, Fahad, 2005. "Third party purchasing of health services: Patient choice and agency," Journal of Health Economics, Elsevier, vol. 24(6), pages 1132-1153, November.
  4. John Leach, 2007. "Ex Post Welfare under Alternative Health Care Systems," Department of Economics Working Papers 2007-05, McMaster University.
  5. Efraim Sadka, 2007. "Public-Private Partnerships: A Public Economics Perspective," CESifo Economic Studies, CESifo, vol. 53(3), pages 466-490, September.
  6. Wildasin, David E., 2004. "The Institutions of Federalism: Toward an Analytical Framework," National Tax Journal, National Tax Association, vol. 57(2), pages 247-72, June.
  7. Maynard, Alan, 1994. "Can competition enhance efficiency in health care? Lessons from the reform of the U.K. National Health Service," Social Science & Medicine, Elsevier, vol. 39(10), pages 1433-1445, November.
  8. BOADWAY, Robin & LEITE-MONTEIRO, Manuel & MARCHAND, Maurice & PESTIEAU, Pierre, 2001. "Social insurance and redistribution," CORE Discussion Papers 2001041, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  9. Wagstaff, Adam & van Doorslaer, Eddy, 2000. "Chapter 34 Equity in health care finance and delivery," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 34, pages 1803-1862 Elsevier.
  10. Avinash Dixit, 2002. "# Incentives and Organizations in the Public Sector: An Interpretative Review," Journal of Human Resources, University of Wisconsin Press, vol. 37(4), pages 696-727.
  11. BOADWAY, Robin & LEITE-MONTEIRO, Manuel & MARCHAND, Maurice & PESTIEAU, Pierre, 2004. "Social insurance and redistribution with moral hazard and adverse selection," CORE Discussion Papers 2004083, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  12. Breyer, Friedrich & Haufler, Andreas, 1999. "Health care reform: Separating insurance from income redistribution," Discussion Papers, Series I 296, University of Konstanz, Department of Economics.
  13. Oliver Hart, 2002. "Incomplete Contracts and Public Ownership: Remarks, and an Application to Public-Private Partnerships," The Centre for Market and Public Organisation 02/061, Department of Economics, University of Bristol, UK.
  14. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459 Elsevier.
  15. Sean Sullivan, 2010. "US health care reform: a work in progress," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 117-118, April.
  16. Carol Propper & Simon Burgess & Denise Gossage, 2008. "Competition and Quality: Evidence from the NHS Internal Market 1991-9," Economic Journal, Royal Economic Society, vol. 118(525), pages 138-170, 01.
  17. Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118 Elsevier.
  18. Hoppe, Eva I & Schmitz, Patrick W, 2008. "Public Versus Private Ownership: Quantity Contracts and the Allocation of Investment Tasks," CEPR Discussion Papers 7056, C.E.P.R. Discussion Papers.
  19. Sebastian Gechert, 2010. "Supplementary Private Health Insurance in Selected Countries: Lessons for EU Governments?," CESifo Economic Studies, CESifo, vol. 56(3), pages 444-464, September.
  20. Julian Le Grand, 2007. "Introduction to The Other Invisible Hand: Delivering Public Services through Choice and Competition
    [The Other Invisible Hand: Delivering Public Services through Choice and Competition]    ," Introductory Chapters, Princeton University Press.
  21. Cutler, David, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical Care Reform," Scholarly Articles 2640584, Harvard University Department of Economics.
  22. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
  23. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643 Elsevier.
  24. Cremer, H. & Pestieau, P., . "Redistributive taxation and social insurance," CORE Discussion Papers RP 1235, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  25. Patrick Bolton & Mathias Dewatripont, 2005. "Contract Theory," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262025760, December.
  26. Fred Schroyen, 2010. "Operational expressions for the marginal cost of indirect taxation when merit arguments matter," International Tax and Public Finance, Springer, vol. 17(1), pages 43-51, February.
  27. Marc Fleurbaey, 2009. "Beyond GDP: The Quest for a Measure of Social Welfare," Journal of Economic Literature, American Economic Association, vol. 47(4), pages 1029-75, December.
  28. Besley, Timothy, 2007. "Principled Agents?: The Political Economy of Good Government," OUP Catalogue, Oxford University Press, number 9780199283910, December.
  29. Selden, Thomas M., 1997. "More on the economic efficiency of mixed public/private insurance," Journal of Public Economics, Elsevier, vol. 66(3), pages 517-523, December.
  30. Jean-Charles Rochet, 1991. "Incentives, Redistribution and Social Insurance," The Geneva Risk and Insurance Review, Palgrave Macmillan, vol. 16(2), pages 143-165, December.
  31. Wilson, Charles, 1977. "A model of insurance markets with incomplete information," Journal of Economic Theory, Elsevier, vol. 16(2), pages 167-207, December.
  32. Petretto, Alessandro, 1999. "Optimal social health insurance with supplementary private insurance," Journal of Health Economics, Elsevier, vol. 18(6), pages 727-745, December.
  33. Gravelle, Hugh & Siciliani, Luigi, 2008. "Optimal quality, waits and charges in health insurance," Journal of Health Economics, Elsevier, vol. 27(3), pages 663-674, May.
  34. Hansen, Bodil O. & Keiding, Hans, 2002. "Alternative health insurance schemes: a welfare comparison," Journal of Health Economics, Elsevier, vol. 21(5), pages 739-756, September.
  35. Blomqvist, A. & Johansson, P-O., 1997. "Economic efficiency and mixed public/private insurance," Journal of Public Economics, Elsevier, vol. 66(3), pages 505-516, December.
  36. Gary S. Becker, 2007. "Health as human capital: synthesis and extensions -super-1," Oxford Economic Papers, Oxford University Press, vol. 59(3), pages 379-410, July.
  37. Oliver E. Williamson, 2005. "The Economics of Governance," American Economic Review, American Economic Association, vol. 95(2), pages 1-18, May.
  38. David M. Cutler, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical-Care Reform," Journal of Economic Literature, American Economic Association, vol. 40(3), pages 881-906, September.
  39. Hoel, Michael, 2007. "What should (public) health insurance cover?," Journal of Health Economics, Elsevier, vol. 26(2), pages 251-262, March.
  40. Kifmann, Mathias, 2002. "Community rating in health insurance and different benefit packages," Journal of Health Economics, Elsevier, vol. 21(5), pages 719-737, September.
  41. Richard Anderson & Michael Grossman, 2009. "Health and the household," Review of Economics of the Household, Springer, vol. 7(3), pages 219-226, September.
  42. Schroyen, Fred, 2005. "An alternative way to model merit good arguments," Journal of Public Economics, Elsevier, vol. 89(5-6), pages 957-966, June.
  43. Nyman, John A., 1999. "The economics of moral hazard revisited," Journal of Health Economics, Elsevier, vol. 18(6), pages 811-824, December.
Full references (including those not matched with items on IDEAS)

Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

as in new window


Cited by:

  1. Lisa Grazzini & Alessandro Petretto, 2013. "Health and Education: Challenges and Financial Constraints," Working Papers - Economics wp2013_19.rdf, Universita' degli Studi di Firenze, Dipartimento di Scienze per l'Economia e l'Impresa.

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

Access and download statistics

When requesting a correction, please mention this item's handle: RePEc:frz:wpaper:wp2010_09.rdf. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Giorgio Ricchiuti)

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.