Beyond the public-private debate: the mixed economy of health

John ØVretveit

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Can or should private organisations provide public healthcare services? What is the scope for private finance in public healthcare services? This paper reviews some of the arguments for and against public or private ownership management and financing of public healthcare services. It concentrates on health services, where non-economic values and ethical questions are as important as the efficiency considerations, and on health purchasing or funding organisations. The paper describes the increasingly complex interrelationship and forms of competition between public and private providers, purchasers and financiers in the UK health sector. It argues that the simple private/public distinction never did describe well the many different forms of financing ownership and operation of health services in any country and is now a handicap to both scientific and lay policy debate about future options. It proposes a framework for describing the main forms of ownership and operation of health services and considers the future for health service purchasing and funding.

Original languageEnglish
Pages (from-to)75-93
Number of pages19
JournalHealth Policy
Volume35
Issue number1
DOIs
Publication statusPublished - Jan 1996
Externally publishedYes

Keywords

  • Healthcare
  • Healthcare reform
  • Private finance and ownership
  • Public sector

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