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Health system reforms in industrialized democracies: an emerging paradigm
1Health Policy and Management Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
The Milbank Quarterly
|January 1, 1995
Summary
A new healthcare paradigm emerges in democracies, blending public finance for universal access with market competition for efficiency and satisfaction. This model focuses on financing, organization, and care provision.
Area of Science:
- Health Policy
- Healthcare Management
- Public Health
Background:
- Industrialized democracies exhibit diverse healthcare systems.
- Recent reforms indicate an emerging universal paradigm for healthcare financing, organization, and macromanagement.
Purpose of the Study:
- To identify the characteristics of the emerging universal healthcare paradigm.
- To analyze the integration of public finance and market principles in healthcare reforms.
Main Methods:
- Analysis of healthcare system reforms in industrialized democracies over the past decade.
- Examination of the systemic functions of financing, organization, and provision of care.
Main Results:
- The emerging paradigm combines public finance principles (universal access, spending control) with market principles (consumer satisfaction, efficiency).
- Key functions include: (1) public finance-based care financing, (2) organization/management of care consumption (public or private entities), and (3) market-based care provision.
- This structure facilitates two internal markets for consumer choice, with the second function being central.
Conclusions:
- A universal healthcare paradigm is consolidating across industrialized democracies.
- This paradigm seeks to balance equity and efficiency through a hybrid public-private approach.
- The organizational and management function is critical to the success of this emerging model.
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