Competition in the Provision of Healthcare The Experience of the US, Sweden and Britain

With mounting political and economic pressures upon health care infrastructure, many developed countries have taken steps to control health care expenditures. This has taken place against a backdrop of increased demand associated with changing demographic structures, technological advance and increasing consumer expectations. - - Consequently the nature of health care provision in Sweden and in Britain has experienced change in recent years. Both countries have witnessed a separation of purchasers from providers and the promotion of provider competition. Implicit in this approach are aspirations about the ability of competitive markets to promote efficiency, effectiveness and value for money, while at the same time cultivating quality and extending consumer choice. - - Beginning with an analysis of the US, where markets have been an inveterate feature of health care provision, the authors seek to compare and contrast the US experience with developments in Sweden and Britain. The analysis takes place within a general framework which gives recognition to issues such as efficiency and effectiveness, cost control, equity and consumer choice.