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Are health care ‘choice – and – competition’ reforms really efficiency driven?

Costa-i-Font, Joan ORCID: 0000-0001-7174-7919 and Zigante, Valentina ORCID: 0000-0002-9246-5862 (2012) Are health care ‘choice – and – competition’ reforms really efficiency driven? LSE Health working papers (26/2012). LSE Health, London School of Economics and Political Science, London, UK.

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Are choice and competition reforms only a route to improving economic efficiency or, do other goals buttress the so-called choice agenda? We here examine evidence of alternative explanations for drivers of choice reforms. More specifically, we explore whether there is evidence consistent with political incumbents’ aspirations to satisfy middle (median) classes (voters), alongside providers capture and service modernisation agendas as potential drivers. We concentrate on health care sector reforms given its central role as a reference universal welfare service - and focus on eight European countries where there has been heterogeneous experimentation with choice and competition reforms. Our findings suggest that whilst competition and choice reforms are primarily driven by the attainment of micro-efficiency and modernisation goals, middle class politics and to a some extent provider interests, appear to also prompt choice reforms. Hence, we conclude that allocative efficiency is not the sole driver of choice reforms.

Item Type: Monograph (Working Paper)
Official URL:
Additional Information: © 2012 the Authors
Divisions: European Institute
Social Policy
LSE Health
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RA Public aspects of medicine
Date Deposited: 08 Mar 2012 16:28
Last Modified: 16 May 2024 11:57

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