@article{836707c836844c0590116c188e8a5905,
title = "Can public healthcare afford marketization? Market principles, mechanisms, and effects in five health systems",
abstract = "Policymakers now have four decades{\textquoteright} experience using marketization to address cost and quality problems in public-sector health services. While much is known about the challenges, it is difficult to draw lessons because there remains no agreed-upon definition of marketization. This article contributes a definition that focuses on the transaction, particularly the effects of funding arrangements on the intensity of competition among providers. Based on prior literature and 106 interviews with practitioners and researchers in five countries, the authors contribute a systematization of 12 concrete market mechanisms enacting three market principles. Furthermore, the authors analyze respondents' perceptions of healthcare marketization's effects on costs and quality. While marketization is a multi-faceted, sometimes ambiguous phenomenon requiring further research before definite conclusions can be reached, most statements from our respondents about cost and quality effects were negative.",
author = "Nick Krachler and Ian Greer and Charles Umney",
note = "Funding Information: We would like to thank Professor Hall and three anonymous reviewers for their helpful advice and constructive comments. Additionally, we would like to thank Tit Albreht, Jean‐Paul Domin and Charalampos Economou for their contributions as country expert interviewees. This research received funding through the European Research Council Starter Grant number 313613: {\textquoteleft}The Effects of Marketization on Societies: the Case of Europe (TEMS){\textquoteright}. This research also benefited from presentation at the 25th International Conference of Europeanists and very useful comments from Jason Beckfield and Sigrun Olafsdottir. Rose Batt and Harry Katz also gave us very useful comments on an early draft at a Cornell University workshop on “Marketization and Neoliberal Restructuring in Europe” in 2016. Moreover, we received helpful comments from Rolle Alho, Charalampos Economou, and Karin Gottschall on a recent draft. The research also benefited from conversations with Maria Mantynen, Andrew Morton, Lefteris Kretsos, and Barbara Samaluk. Publisher Copyright: {\textcopyright} 2021 The Authors. Public Administration Review published by Wiley Periodicals LLC on behalf of American Society for Public Administration. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = apr,
day = "7",
doi = "10.1111/puar.13388",
language = "English",
journal = "PUBLIC ADMINISTRATION REVIEW",
issn = "0033-3352",
publisher = "Wiley-Blackwell",
}