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The New NHS in a Global Context: is it taking us where we want to be?1

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Abstract

In this paper, the new NHS is put in a global context, comparing the UK internal market arrangements with changes occurring in other health care systems. An assessment is made of whether the new UK NHS will result in more efficient and equitable health care provision than the ‘old’ NHS. Regarding financing of health care, most countries seem to be moving in the direction of NHS or public-insurance-based systems. New Zealand and The Netherlands are among the few countries attempting to inject competition into health care financing. There is a greater move, globally, towards competition in the provision of services. In terms of allocative efficiency and equity, we believe that, on balance, the new NHS will bring no improvement. Indeed, in terms of equity, it may be detrimental. If there is any improvement, it is likely to be in technical efficiency.

Keywords

Social Preference Global Context Health Care Financing Allocative Efficiency Audit Movement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Brittan, L. (1988) A New Deal for Health Care (London: Conservative Political Centre).Google Scholar
  2. Butler, E. and Pirie, M. (1988) The Health of Nations (London: Adam Smith Institute).Google Scholar
  3. Culyer, A.J. (1991) ‘The normative economics of health care finance and provision’, in A. McGuire., P. Fenn and K. Mayhew, (eds) Providing Health Care: The Economics of Alternative Systems of Finance and Delivery 65–98. (Oxford: Oxford University Press).Google Scholar
  4. Dearden, B. (1991) ‘First welfare state at end of the road’, Health Service Journal, 8 August, 15.Google Scholar
  5. Donaldson, C. and Gerard, K. (1989) ‘Countering moral hazard in public and private health care systems: a review of recent evidence’, Journal of Social Policy, 18, 235–51.CrossRefGoogle Scholar
  6. Donaldson, C. and Gerard, K. (1993) Economics of Health Care Financing: the Visible Hand (London: Macmillan).Google Scholar
  7. Evans, R.G. (1987) ‘Public health insurance: the collective purchase of individual care’, Health Policy, 7, 115–34.CrossRefGoogle Scholar
  8. Evans, R.G. (1990) ‘Tension, compression and shear: directions, stresses and outcomes of health care cost control’, Journal of Health Politics Policy and Law, 15, 101–28.CrossRefGoogle Scholar
  9. Farley, J.P. (1985) ‘Who are the underinsured?’, Milbank Memorial Fund Quarterly, 63, 476–503.CrossRefGoogle Scholar
  10. Farrar, S. (1993) ‘NHS reforms and resource management: whither the hospital?’, Health Policy, 26, 93–104.CrossRefGoogle Scholar
  11. Ginsburg, P.B. (1988) ‘Public insurance programs: Medicare and Medicaid’, in H.E. Frech III (ed.) Health Care in America: the Political Economy of Hospitals and Health Insurance (San Francisco: Pacific Research Institute for Public Policy).Google Scholar
  12. Hakansson, S., Majnoni d’Intignano, B., Roberts, J. and Zollner, H. (1988) The Leningrad experiment in health care management 1988. Report of a visit to the USSR (Copenhagen: World Health Organisation).Google Scholar
  13. Healey, A.T., Yule, B. and Reid, J.P. (1994) ‘Variation in general practice prescribing costs and implications for budget setting’, Health Economics 3, 47–56.CrossRefGoogle Scholar
  14. Himmelstein, D.U. and Woolhandler, S. (1986) ‘Cost without benefit: administrative waste in the US health care system’, New England Journal of Medicine, 314, 441–5.CrossRefGoogle Scholar
  15. Hopkins, A. (1992) ‘Response to Mooney and Ryan’, Journal of Epidemiology and Community Health, 46, 183.Google Scholar
  16. Italian Ministry of Justice (1988) Legge 838: Institutzione del Sanitario, Supplement to Tazzotta Ufficcale, 28, December 1978, Rome 1978.Google Scholar
  17. Letwin, O. and Redwood, J. (1988) Britain’s Biggest Enterprise (London: Centre for Policy Studies).Google Scholar
  18. Matsaganis M. and Glennerster H. (1994) ‘The threat of “cream skimming” in the post-reform NHS’, Journal of Health Economics, 13, 31–60.CrossRefGoogle Scholar
  19. Melnick, G.A. and Zwanziger, J. (1988) ‘Hospital behaviour under competition and cost containment policies: the California experience, 1980 to 1985’, Journal of the American Medical Association, 260, 2660–75.Google Scholar
  20. Ministerio de Sanidad y Consumo (1989) The Spanish Health System Highlights, Direction General de Planeficacion Sanitoria, Madrid.Google Scholar
  21. Mooney, G. and Salmond, G. (1995) ‘A reflection on New Zealand health care reform’, Health Policy.Google Scholar
  22. NHS Management Executive (1992) Local Voices: the Views of Local People in Purchasing for Health (London: NHS Management Executive.)Google Scholar
  23. Palmer, G. and Short, S.D. (1989) Health Care and Public Policy: an Australian Analysis (Melbourne: Macmillan).Google Scholar
  24. Quam, L. (1989) ‘Post-war American health care: the many costs of market failure’, Oxford Review of Economic Policy, 5, 113–23.CrossRefGoogle Scholar
  25. Richardson, J. (1987) ‘Ownership and regulation in the health care sector’, in P. Abelson (ed.), Privatisation: an Australian Perspective (Sydney: Australian Professional Publications).Google Scholar
  26. Ryan, M. and Yule, B. (1993) ‘The way to economic prescribing’, Health Policy 25, 25–38.CrossRefGoogle Scholar
  27. Scott, C. (1994) ‘Reform of the New Zealand health care system’, Health Policy 29, 25–40.CrossRefGoogle Scholar
  28. Secretaries of State for Health Wales, Northern Ireland and Scotland, (1989) Working for Patients (London: HMSO).Google Scholar
  29. Shackley, P. and Healey, A. (1993) ‘Creating a market: an economic analysis of the purchaser-provider model’, Health Policy 25, 153–68.CrossRefGoogle Scholar
  30. Sheldon, T. (1994) ‘Public health reforms have failed, say Ministers’, British Medical Journal, 308, 936.Google Scholar
  31. Van de Ven, W.M.M. (1989) ‘A Future for Competitive Health Care in the Netherlands’, NHS White Paper Series, Occasional Paper No. 9, Centre for Health Economics, University of York.Google Scholar
  32. Wilensky, G.R. (1988) ‘Filling the gaps in health insurance’, Health Affairs, 7, 133–49.CrossRefGoogle Scholar
  33. Woolhandler, S. and Himmelstein, D.U. (1991) ‘The deteriorating administrative efficiency of the US health care system’, New England Journal of Medicine, 324, 1253–8.CrossRefGoogle Scholar

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© Elsevier Publishing Co. Ltd 1997

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