Public/private health care: The British scenario

Abstract

The issue of public versus private health care is too often treated as an ideological issue, with each side unwilling to discuss common problems of cost containment and quality control which have to be faced, no matter what the financial framework. Thus, cost containment will worry the administrators of insurance funds just as much, if not more, than health service administrators. Health care is not, in the economist's sense, a perfect market; it cannot and does not remain unregulated. So what is at issue is whether regulation is carried out by government, by insurance companies, or by the professions, and what the balance between them shall be.

These and other lessons are drawn from a series of studies describing the workings of insurance systems in a number of countries, in Europe, as well as the United States, Canada and Australia. The findings of the book ‐ The Public/Private Mix for Health, edited by Gordon McLachlan and Alan Maynard, and published this autumn by the Nuffield Provincial Hospitals Trust ‐ are too rich to be summarised here. What follows is an extract from the final chapter containing the editors’ own reflections on the material they have brought together.