Van De Ven W, (1996)

‘Market-Orientated Health Care Reforms: Trends and Future Options’

Social Science and Medicine 43(5): 655-666

Indicates some international trends in health care reforms implemented in order to improve efficiency and increase awareness of consumer preferences, whilst maintaining equity

Global trends identified by the author include:

• A trend to near universal mandatory health insurance.
• Some signs of convergence on the public contract model, i.e. public financing of health care combined with a system of contracts between providers and third-party purchasers of care.
• An increase in the consumers’ freedom to choose a provider.
• A trend towards competition among providers of care in many countries.
• The introduction of market-orientated elements (incentives, regulated competition) in health care has the advantage that it enables the breaking of the vicious circle of ever-increasing health care expenditures.
• The existence of a strong coalition in the health care sector with no interest in cost containment. The author argues that interest in making a trade-off between costs and quality can be given by market elements.

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