Privatization in a publicly funded health care system: the U.S. experience

International Journal of Health Services : Planning, Administration, Evaluation
D U Himmelstein, S Woolhandler

Abstract

The United States has four decades of experience with the combination of public funding and private health care management and delivery, closely analogous to reforms recently enacted or proposed in many other nations. Extensive research, herein reviewed, shows that for-profit health institutions provide inferior care at inflated prices. The U.S. experience also demonstrates that market mechanisms nurture unscrupulous medical businesses and undermine medical institutions unable or unwilling to tailor care to profitability. The commercialization of care in the United States has driven up costs by diverting money to profits and by fueling a vast increase in management and financial bureaucracy, which now consumes 31 percent of total health spending. The Veterans Health Administration system--a network of government hospitals and clinics--has emerged as the leader in quality improvement and information technology, indicating the potential for public sector excellence and innovation. The poor performance of U.S. health care is directly attributable to reliance on market mechanisms and for-profit firms, and should warn other nations from this path.

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Citations

Jul 5, 2013·International Journal of Health Services : Planning, Administration, Evaluation·Stephen Nkansah-AmankraReuben Jonathan Miller
May 8, 2009·Western Journal of Nursing Research·Lori Lea PopejoyColleen Galambos
Mar 11, 2010·Scandinavian Journal of Public Health·Anne M KoponenSakari Suominen
Apr 5, 2019·Journal of Immigrant and Minority Health·Nadia A CharaniaNikki M Turner
Aug 6, 2011·Health Marketing Quarterly·Cheryl-Ann N WilliamsDavid Loudon
Aug 9, 2017·Globalization and Health·Gerald BloomAlain Labrique
Oct 21, 2019·Journal of Epidemiology and Community Health·Ian W Watson, Sanda Cristina Oancea

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