In lots of countries, health services have traditionally been publicly managed and financed. But in recent many years, several countries have undergone major health reforms, inspired by more market pondering.
The primary argument for this trend is that increased competition will provide higher and more efficient health services. Nevertheless, the outcomes from recent research indicate that the population still prefers health services to be mainly publicly regulated and financed.
We found that Europeans are generally most satisfied in countries where the general public sector is in control of many of the health care system.”
Pål Erling Martinussen, Professor in NTNU’s (the Norwegian University of Science and Technology) Department of Sociology and Political Science
Martinussen has collaborated with Håvard Thorsen Rydland from the Norwegian Research Centre (NORCE) to check health care in 21 European countries. The researchers checked out the connection between the degree of market adaptation of the health care system and the way satisfied patients are.
More freedom of alternative, but less satisfaction
The health reforms are designed to strengthen patient rights and introduce greater freedom of alternative and competition. As well as, various financial incentives within the health sector have opened up for more offers based on profit and personal payment.
“In brief, this hasn’t resulted in additional satisfied patients,” Martinussen says.
Few researchers have previously studied the effect that every one the reforms have had on health services. And even fewer have examined how satisfied the population is with the services afterwards.
“The truth is, nobody has used the population’s satisfaction as a measure of the success of the changes,” Martinussen.
The researchers examined the degree of health care privatization in the assorted countries by the proportion of public funding of the health services, the proportion of personal hospital beds and the degree of public coverage. The methods enabled the researchers to see results over each short and long periods of time.
How Norway did it
Norway introduced effort-driven financing in 1997, in order that hospitals receive a part of their income based on what number of patients they treat. With the hospital reform in 2002, hospitals were organized into enterprises. Here the philosophy is that the general public sector orders services, and the providers can be private.
“Key elements of the reform are greater hospital independence, more centralized power to the state, increased use of contracts as a form of presidency, professionals as a substitute of joint boards, greater separation between health policy and repair production and increased freedom of alternative for patients,” says Martinussen.
The changes were a part of the market-oriented reform wave that has washed over the general public sector in lots of countries under the collective term “Latest Public Management” in recent times.
Competition amongst providers also has benefits
“It’s clear that there are also benefits to competition in a public system. Private actors have relieved among the pressure on the general public health service,” says Martinussen.
The researchers indicate that the rationale this works so well in Norway and the opposite Nordic countries, for instance, is that only the providers are private. Funding and regulations remain public.
“We have actually found support for this, in that the inhabitants of nations with a bigger share of personal providers are more satisfied. So plainly people don’t find it critical who offers the health services, so long as they’re publicly managed and financed,” says Martinussen.
Source:
Norwegian University of Science and Technology
Journal reference:
Martinussen, P.E., et al. (2022) (I can not get no) satisfaction: A comparative study of healthcare recommodification in Europe, 2010-18. Social Science & Medicine. doi.org/10.1016/j.socscimed.2022.115083.