Title: Accountability of Health Service Purchasers: Comparing Internal Markets and Managed Competition Reform Models
Abstract: A number of countries, including the U.K., New Zealand, the Netherlands, and the U.S., have attempted to reform their health care systems using internal market or managed competition reform models. These models signal a departure from reliance on passive indemnity payers or insurers and require proactive purchasers to intervene actively and manager allocation decisions made by physicians. The author explores how these models will ensure the accountability of these new decision-makers to the citizens and patients they ultimately represent. Neither model is found to address accountability issues sufficiently. However, the managed competition model offers the promise of tailoring market (exit), political (voice) and regulatory mechanisms to create the optimal mix of incentive. It is argued that every type of health system (including Canada's) has long overlooked accountability and governance mechanism. Decision-makers must have incentives to make decisions which strike the right balance between patients' needs and societal interest, and more generally between equity and efficiency. Solving this key problem demands the attention of policymakers, lawyers, and economists.
Publication Year: 2008
Publication Date: 2008-06-20
Language: en
Type: article
Access and Citation
Cited By Count: 2
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot