IDEAS home Printed from https://ideas.repec.org/p/ohe/briefg/002055.html
   My bibliography  Save this paper

Private Provision of Publicly Funded Health Care: The Economics of Ownership

Author

Listed:
  • Martin Chalkley

Abstract

This OHE Briefing outlines the NHS ownership debate through the lens of economics. The aim of the Briefing is to improve understanding of how economics can or cannot help to resolve the question of whether the private ownership of health care provision is good or bad. The economics literature that informs this overview includes: the theory of the organisation of production; theories of behaviour and motivation and the role of incentives and payments in influencing decisions. There are strongly stated concerns regarding the increasing use of non-publicly owned, especially for-profit, firms to provide services: concerns that the NHS is being undermined, that future services will be at risk or even that health care that is free at the point of delivery – a key tenet of the NHS – is about to be abandoned. There are, however, also staunch defenders of the role of the private sector in health care who argue that private providers increase patient choice, reduce waiting times and drive innovation and efficiency improvements. Depending on the viewpoint, private ownership is either a disaster or a salvation for the NHS. This OHE Briefing outlines the NHS ownership debate through the lens of economics. The aim of the Briefing is to improve understanding of how economics can or cannot help to resolve the question of whether the private ownership of health care provision is good or bad. The economics literature that informs this overview includes: the theory of the organisation of production; theories of behaviour and motivation and the role of incentives and payments in influencing decisions.

Suggested Citation

  • Martin Chalkley, 2018. "Private Provision of Publicly Funded Health Care: The Economics of Ownership," Briefing 002055, Office of Health Economics.
  • Handle: RePEc:ohe:briefg:002055
    as

    Download full text from publisher

    File URL: https://www.ohe.org/publications/private-provision-publicly-funded-health-care-economics-ownership/attachment-ohe-briefing-economics-of-ownership/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Oliver Hart & John Moore, 2008. "Contracts as Reference Points," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(1), pages 1-48.
    2. Moscelli, Giuseppe & Gravelle, Hugh & Siciliani, Luigi & Gutacker, Nils, 2018. "The effect of hospital ownership on quality of care: Evidence from England," Journal of Economic Behavior & Organization, Elsevier, vol. 153(C), pages 322-344.
    3. Cristian A Herrera & Gabriel Rada & Lucy Kuhn-Barrientos & Ximena Barrios, 2014. "Does Ownership Matter? An Overview of Systematic Reviews of the Performance of Private For-Profit, Private Not-For-Profit and Public Healthcare Providers," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-18, December.
    4. Martine Marie Bellanger & Philippe Mossé, 2005. "The search for the holy Grail : combining decentralised planning and contracting mechanisms in the French health care system," Post-Print halshs-00551874, HAL.
    5. Oliver Hart & John Moore, 2007. "Incomplete Contracts and Ownership: Some New thoughts," American Economic Review, American Economic Association, vol. 97(2), pages 182-186, May.
    6. Joskow, Paul L. & Rose, Nancy L., 1989. "The effects of economic regulation," Handbook of Industrial Organization, in: R. Schmalensee & R. Willig (ed.), Handbook of Industrial Organization, edition 1, volume 2, chapter 25, pages 1449-1506, Elsevier.
    7. Holmstrom, Bengt & Milgrom, Paul, 1991. "Multitask Principal-Agent Analyses: Incentive Contracts, Asset Ownership, and Job Design," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 7(0), pages 24-52, Special I.
    8. Yasuo Sanjo, 2009. "Quality choice in a health care market: a mixed duopoly approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(2), pages 207-215, May.
    9. Timothy Besley & Maitreesh Ghatak, 2003. "Incentives, Choice, and Accountability in the Provision of Public Services," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 19(2), pages 235-249, Summer.
    10. Wim Biesen & Norbert Lameire & Patrick Peeters & Raymond Vanholder, 2007. "Belgium’s mixed private/public health care system and its impact on the cost of end-stage renal disease," International Journal of Health Economics and Management, Springer, vol. 7(2), pages 133-148, September.
    11. Gian Paolo Barbetta & Gilberto Turati & Angelo M. Zago, 2007. "Behavioral differences between public and private not‐for‐profit hospitals in the Italian national health service," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 75-96, January.
    12. Ernst Fehr & Oliver Hart & Christian Zehnder, 2011. "Contracts as Reference Points--Experimental Evidence," American Economic Review, American Economic Association, vol. 101(2), pages 493-525, April.
    13. Ernst Fehr & Oliver Hart & Christian Zehnder, 2008. "Contracts as reference points � experimental evidence," IEW - Working Papers 393, Institute for Empirical Research in Economics - University of Zurich.
    14. Pérotin, Virginie & Zamora, Bernarda & Reeves, Rachel & Bartlett, Will & Allen, Pauline, 2013. "Does hospital ownership affect patient experience? An investigation into public–private sector differences in England," Journal of Health Economics, Elsevier, vol. 32(3), pages 633-646.
    15. Dranove, David & Satterthwaite, Mark A., 2000. "The industrial organization of health care markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 20, pages 1093-1139, Elsevier.
    16. Martine M. Bellanger & Philippe R. Mossé, 2005. "The search for the Holy Grail: combining decentralised planning and contracting mechanisms in the French health care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 119-132, September.
    17. Bronwyn Croxson, 1999. "Organisational Costs in the New NHS," Monograph 000450, Office of Health Economics.
    18. Luigi Siciliani & Peter Sivey & Andrew Street, 2013. "Differences In Length Of Stay For Hip Replacement Between Public Hospitals, Specialised Treatment Centres And Private Providers: Selection Or Efficiency?," Health Economics, John Wiley & Sons, Ltd., vol. 22(2), pages 234-242, February.
    19. OHE Commission, 2012. "Report of the Office of Health Economics Commission on Competition in the NHS," Monographs, Office of Health Economics, number 000168.
    20. Office of Health Economics, 2009. "How Fair? Competition between Independent and NHS Providers to Supply Non-Emergency Hospital Care to NHS Patients in England," Briefing 000230, Office of Health Economics.
    21. Midttun, Linda & Hagen, Terje P., 2006. "The private–public mix of healthcare: evidence from a decentralised NHS country," Health Economics, Policy and Law, Cambridge University Press, vol. 1(3), pages 277-298, July.
    Full references (including those not matched with items on IDEAS)

    Citations

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


    Cited by:

    1. Tafesse, Wiktoria & Chalkley, Martin, 2021. "Faith-based provision of sexual and reproductive healthcare in Malawi," Social Science & Medicine, Elsevier, vol. 282(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jiao Luo & Aseem Kaul, 2019. "Private action in public interest: The comparative governance of social issues," Strategic Management Journal, Wiley Blackwell, vol. 40(4), pages 476-502, April.
    2. Schmitz, Patrick W., 2021. "On the optimality of outsourcing when vertical integration can mitigate information asymmetries," Economics Letters, Elsevier, vol. 202(C).
    3. Luis Garicano & Luis Rayo, 2016. "Why Organizations Fail: Models and Cases," Journal of Economic Literature, American Economic Association, vol. 54(1), pages 137-192, March.
    4. Tongwei Qiu & Biliang Luo & Qinying He, 2020. "Does Land Rent between Acquaintances Deviate from the Reference Point? Evidence from Rural China," China & World Economy, Institute of World Economics and Politics, Chinese Academy of Social Sciences, vol. 28(3), pages 29-50, May.
    5. Hong, Fuhai & Hossain, Tanjim & List, John A., 2015. "Framing manipulations in contests: A natural field experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 118(C), pages 372-382.
    6. Contreras Oscar F. & Giorgio Zanarone, 2018. "Managing Social Comparison Costs in Organizations," Working Papers 2018-25, Banco de México.
    7. Sloof, Randolph & Sonnemans, Joep, 2011. "The interaction between explicit and relational incentives: An experiment," Games and Economic Behavior, Elsevier, vol. 73(2), pages 573-594.
    8. Maloney, Michael T., 2017. "Alchian remembrances," Journal of Corporate Finance, Elsevier, vol. 44(C), pages 561-582.
    9. Graham, John R. & Grennan, Jillian & Harvey, Campbell R. & Rajgopal, Shivaram, 2022. "Corporate culture: Evidence from the field," Journal of Financial Economics, Elsevier, vol. 146(2), pages 552-593.
    10. Schmidt, Klaus, 2017. "The 2016 Nobel Memorial Prize in Contract Theory," Rationality and Competition Discussion Paper Series 19, CRC TRR 190 Rationality and Competition.
    11. René Carmona, 2022. "The influence of economic research on financial mathematics: Evidence from the last 25 years," Finance and Stochastics, Springer, vol. 26(1), pages 85-101, January.
    12. Thomas Hellmann & Veikko Thiele, 2011. "Incentives and Innovation: A Multitasking Approach," American Economic Journal: Microeconomics, American Economic Association, vol. 3(1), pages 78-128, February.
    13. Geczy, Christopher & Jeffers, Jessica S. & Musto, David K. & Tucker, Anne M., 2021. "Contracts with (Social) benefits: The implementation of impact investing," Journal of Financial Economics, Elsevier, vol. 142(2), pages 697-718.
    14. Corgnet, Brice & Martin, Ludivine & Ndodjang, Peguy & Sutan, Angela, 2019. "On the merit of equal pay: Performance manipulation and incentive setting," European Economic Review, Elsevier, vol. 113(C), pages 23-45.
    15. Müller, Daniel & Schmitz, Patrick W., 2016. "Vertragstheorie: Zum Nobelpreis 2016 für Oliver Hart und Bengt Holmström [Contract Theory: On the Contributions of the 2016 Nobel Laureates Oliver Hart and Bengt Holmström]," MPRA Paper 75233, University Library of Munich, Germany.
    16. Ju. Voronov P. & Ю. Воронов П., 2017. "О теории контрактов (о Нобелевских премиях по экономике) // About the Contract Theory (about Nobel Prizes on Economy)," Мир новой экономики // The world of new economy, Финансовый университет при Правительстве Российской Федерации // Financial University under The Governtment оf The Russian Federation, issue 1, pages 92-102.
    17. Schmitz, Patrick W., 2015. "Government versus private ownership of public goods: The role of bargaining frictions," Journal of Public Economics, Elsevier, vol. 132(C), pages 23-31.
    18. Ricard Gil & Jordi Mondria, 2011. "Introducing managerial attention allocation in incentive contracts," SERIEs: Journal of the Spanish Economic Association, Springer;Spanish Economic Association, vol. 2(3), pages 335-358, September.
    19. Kim, Minseong, 2019. "Firms as problem solvers: economics meets computer science," MPRA Paper 97332, University Library of Munich, Germany.
    20. Levaggi, Laura & Levaggi, Rosella, 2020. "Is there scope for mixed markets in the provision of hospital care?," Social Science & Medicine, Elsevier, vol. 247(C).

    More about this item

    Keywords

    Private Provision of Publicly Funded Health Care: The Economics of Ownership;

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ohe:briefg:002055. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Publications Manager (email available below). General contact details of provider: https://edirc.repec.org/data/ohecouk.html .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.