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Privatizing the health-care sector: Expansion of voluntary, private health insurance and private for-profit hospitals in the Nordic countries

By this project, we aim at describing, analysing and discussing the normative aspects of the expansion of voluntary, private health insurance and private for-profit hospitals in a systematic way.

About the project

The project is built upon seven work packages; three covering the analyses of VPHI, three covering the analyses of private for-profit hospitals and one covering the normative aspects of the observed trends:

  • WP1: Theoretical discussion of the VPHI market
  • WP2: Supply and demand for VPHI among individuals and firms
  • WP3: VPHI and out-of-pocket payment as “top up” funding mechanisms in specialist care – selection effects
  • WP4: Theoretical discussions of the regulation of private providers
  • WP5: The supply and demand for services from private for-profit hospitals
  • WP6: Use of public and private hospitals – effects on patient selection and quality
  • WP7: Normative aspects of mixed private-public welfare state

For each of the WPs we present topics, research questions and choice of methods in detail. Data will primarily, be collected in Norway, Denmark and Finland.


The growth of voluntary private health insurance and private for-profit hospitals raises a number of important questions about the welfare states.

The European welfare states are facing considerable economic challenges. An increased pressure on public financing has strengthened the need to find political responses without jeopardizing the core principles of the welfare state.

Two policy options under development, also in the Nordic countries, are:

a) to increase the use of private financing of welfare services via voluntary, private health insurance (VPHI) and

b) to open up for private for-profit hospitals in provision of health-care services either funded through VPHI, out-of-pocket payments or public budgets.


A turn to private financing of welfare services represents a shift to a more individualistic way of financing welfare and a more direct link between payments and benefits. A more fundamental shift in funding and organizing of health-care services might be under way, but up until now, there has been limited systematic comparative knowledge about the topic.


The research finding will be of relevance for governmental agencies in Norway, Denmark and Finland, primarily the Ministries of health, national and regional health authorities, health enterprises and hospitals. There will written academic reports in the working paper series at Institute of Health and Society (University of Oslo) and in academic journals (national and international). The University of Oslo have four study programs where information from the project will be disseminated – all these programs recruit and produce future decision makers for health-care sector. Further, results will be communicated at relevant conferences.


The project’s total budget is 5,5 mill NOK. 3,6 million is founded by the Norwegian Research Council.


Start – Finish

2014 -- 2018


Published Mar. 7, 2019 12:03 PM - Last modified Oct. 5, 2020 12:32 PM