How Does Private Finance Affect Public Health Care Systems? Marshalling the Evidence from OECD Nations

Journal of Health Politics, Policy and Law, Vol. 29, No. 3, pp. 359-396, 2004

38 Pages Posted: 20 Jun 2008 Last revised: 7 Aug 2008

See all articles by Carolyn Hughes Tuohy

Carolyn Hughes Tuohy

University of Toronto - Department of Political Science

Colleen M. Flood

University of Ottawa - Faculty of Law

Mark Stabile

INSEAD; National Bureau of Economic Research (NBER)

Abstract

The impact of private finance on publicly funded health care systems depends on how the relationship between public and private finance is structured. This essay first reviews the experience in five nations that exemplify different ways of drawing the public/private boundary to address the particular questions raised by each model. This review is then used to interpret aggregate empirical analyses of the dynamic effects between public and private finance in OECD nations over time. Our findings suggest that while increases in the private share of health spending substitute in part for public finance (and vice versa), this is the result of a complex mix of factors having as much to do with cross-sectoral shifts as with deliberate policy decisions within sectors and that these effects are mediated by the different dynamics of distinctive national models. On balance, we argue that a resort to private finance is more likely to harm than to help publicly financed systems, although the effects will vary depending on the form of private finance.

Keywords: Health Law, Health Care, Health PolicyPublic/Private Interface in Health Care, OECD

Suggested Citation

Tuohy, Carolyn Hughes and Flood, Colleen M. and Stabile, Mark, How Does Private Finance Affect Public Health Care Systems? Marshalling the Evidence from OECD Nations. Journal of Health Politics, Policy and Law, Vol. 29, No. 3, pp. 359-396, 2004, Available at SSRN: https://ssrn.com/abstract=1146608

Carolyn Hughes Tuohy

University of Toronto - Department of Political Science ( email )

Sidney Smith Hall
100 St George Street
Toronto, Ontario M5S 3G3
Canada
416-978-2181 (Phone)
416-488-4071 (Fax)

Colleen M. Flood (Contact Author)

University of Ottawa - Faculty of Law ( email )

57 Louis Pasteur Street
Ottawa, K1N 6N5
Canada
416-697-4594 (Phone)

Mark Stabile

INSEAD ( email )

Boulevard de Constance
F-77305 Fontainebleau Cedex
France

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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