Privatization processes in health care in Europe—a move in the right direction, a ‘trendy’ option, or a step back?

Title Privatization processes in health care in Europe—a move in the right direction, a ‘trendy’ option, or a step back?
Year 2009
Author T. Albreht
DOI 10.1093/eurpub/ckp146
Journal The European Journal of Public Health
Document Type Journal Article
Document Availability Full Text
Classification Policy
Abstract Tit AlbrehtInstitute of Public Health SloveniaCorrespondence: Tit Albreht. e-mail: tit.albreht{at}ivz-rs.siConceptualizing privatization Privatization in health care is a hot topic of discussion in most European countries. Driven by the political agenda, privatization as a general process in the society is often offered as a panacea for all sorts of problems, where health care is seen as one of the potential areas of implementation. This requires some initial delimitations and clear definitions of basic terms. Let us take the definition proposed by the European observatory on health systems and policies: ‘Privatisation is the transfer of ownership AND government functions from public to private bodies, which may consist of voluntary organisations and for-profit and not-for-profit organisations’. In everyday life, we see that these components are taken at leisure and are then combined with different preferences. Therefore, it is useful to develop both concepts as well as criticisms around them. There is a taxonomy proposed by Saltman1, differentiating between different categories of public and private providers: Public State: Ministry of Health, National BoardsPublic, but not state: regional and local government, public corporationsPrivate Not-for-profit (mission-driven): community-based, religious, charitable, NGOsFor-profit (return-driven): small businesses, large corporations Then we need to explore, what part of health care is privatized. We have the typology, proposed by Maarse2: privatization of health care financing, privatization of health care provision, privatization of health care management and privatization of health care investment. It happens rarely that we see all parts of health care privatized at the same time and to the same extent. This typology provides ground for assessing the presence of each component and the extent to which privatization is developed.Reasons for privatization One of the issues that are often skipped but essential in evaluating the impact of any type of privatization is—Why is it necessary? We can see that drivers for privatization are different in the Western …


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