Competition in health care: Lessons from the English experience
File(s)
Author(s)
Propper, C
Type
Journal Article
Abstract
The use of competition and the associated increase in choice in health care is a popular reform model, adopted by many governments across the world. Yet it is also a hotly contested model, with opponents seeing it, at best, as a diversion of energy or a luxury and, at worst, as leading to health care inequality and waste. This paper subjects the use of competition in health care to scrutiny. It begins by examining the theoretical case and then argues that only by looking at evidence can we understand what works and when. The body of the paper examines the evidence for England. For 25 years the United Kingdom has been subject to a series of policy changes which exogenously introduced and then downplayed the use of competition in health care. This makes England a very useful test bed. The paper presents the UK reforms and then discusses the evidence of their impact, examining changes in outcomes, including quality, productivity and the effect on the distribution of health care resources across socio-economic groups. The final section reflects on what can be learnt from these findings.
Date Issued
2018-07-01
Date Acceptance
2017-07-01
Citation
Health Economics, Policy and Law, 2018, 13 (3-4), pp.492-508
ISSN
1744-1331
Publisher
Cambridge University Press
Start Page
492
End Page
508
Journal / Book Title
Health Economics, Policy and Law
Volume
13
Issue
3-4
Copyright Statement
© 2018 Cambridge University Press. This is an Open Access article, distributed under
the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use,
distribution, and reproduction in any medium, provided the original work is properly cited.
the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use,
distribution, and reproduction in any medium, provided the original work is properly cited.
Subjects
1402 Applied Economics
1605 Policy And Administration
1801 Law
Health Policy & Services
Publication Status
Published
Date Publish Online
2018-02-08