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Is contracting a form of privatization?
1Department of Health Systems Financing, World Health Organization, Geneva, Switzerland.
Bulletin of the World Health Organization
|December 5, 2006
Summary
This study explores privatization in the health sector, defining it beyond ownership changes to include behavioral shifts. Contracting serves as a key mechanism for both privatization and state intervention, impacting health sector dynamics.
Area of Science:
- Health Policy and Management
- Public Health
- Health Economics
Background:
- Contracting is frequently viewed as a primary instrument enabling privatization within the health sector.
- Concerns exist regarding the private sector's covert expansion into healthcare through contracting mechanisms.
- The concept of privatization extends beyond mere ownership transfer to encompass significant behavioral changes.
Purpose of the Study:
- To critically examine the multifaceted nature of privatization in the health sector.
- To analyze the diverse methods through which health sector privatization is actualized.
- To explore the role of contracting as a tool for state interventionism distinct from authoritarian regulation.
Main Methods:
- Conceptual analysis of privatization within the health sector context.
- Examination of contracting as a mechanism for privatization and state intervention.
- Assessment of privatization based on ownership, management, and organizational objectives.
Main Results:
- Privatization in healthcare involves not only structural changes but also shifts in operational behavior.
- Contracting can facilitate both the expansion of private sector influence and state-directed interventions.
- The assessment of privatization requires evaluating ownership, management practices, and the core mission of health entities.
Conclusions:
- Privatization in health is a complex process involving behavioral and structural transformations.
- Contracting represents a versatile tool with implications for both private sector growth and state control in healthcare.
- Understanding privatization necessitates a holistic view encompassing ownership, management, and objectives, alongside the nuances of contracting.
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