Friday, March 30, 2018
Exchange North (InterContinental Chicago Magnificent Mile)
The debate in the United States over replacing the 2010 Affordable Care Act revolves
around a longstanding theme in health policy worldwide: the gap between ideas about ‘the
market’ and the real-world political economy of health. Promises and fears of ‘market-based
solutions’ raise two questions that have not received sufficient attention from scholars or
practitioners. What are the principles and practices that change the form of health systems
towards a more market-driven state? How might particular practices affect the cost and quality of
services? Based on descriptive statistics, document analyses, and 120 interviews with relevant
stakeholders, including senior officials in the European Commission, we tackle these questions
and examine five different European health systems that have experienced marketization to
varying degrees over the past 10 years. We provide a theory of healthcare marketization and find
that the effects of marketization are uneven at best and negative most of the time.
