The Search for Cross Subsidy in Segmented Health Systems: Can Private Wards in Public Hospitals Secure Equity Gains?

  • Haroon Wadee
  • Lucy Gilson
Part of the Social Policy in a Development Context book series (SPDC)


The commercialization of health care presents a series of challenges for policy-makers concerned about improving access to health care for poorer groups. Health care tends to be used most by the richer groups of a population, even though they, in general, have better health and are likely to live longer than poorer people. This pattern is only reinforced by the market mechanisms associated with commercialization, such as user fees or private insurance. These entrench ability to pay, rather than health need, as the primary criterion on which resources and health care use are distributed within a population, and so disadvantage the poor. In addition, those health system actors that benefit from commercialization (such as insurers, private providers, the richer users) are likely to oppose any actions that threaten their privileges.


Public Sector Public Hospital Private Provider Public Sector Manager Equity Gain 
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Copyright information

© United Nations Research Institute for Social Development 2005

Authors and Affiliations

  • Haroon Wadee
  • Lucy Gilson

There are no affiliations available

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