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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.

Background

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.

Objectives

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.

Outcomes

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.

Financing

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

Cooperation

Start – Finish

2014 -- 2018

 

Publications

  • Liina-Kaisa Tynkkynen; Nina Alexandersen; Oddvar Martin Kaarbøe; Anders Anell; Juhani S. Lehto & Karsten Vrangbæk (2018). Development of Voluntary Private Health Insurance in Nordic Countries. An Exploratory Study on Country-specific Contextual Factors.. Health Policy.  ISSN 0168-8510.  122, s 485- 492
  • Geir Hiller Holom; Nina Alexandersen; Jeremy D. Goldhaber-Fieber & Terje P. Hagen (2018). Which patients receive surgery in for-profit and non-profit hospitals in a universal health system? An explorative register-based study in Norway. BMJ Open.  ISSN 2044-6055.  8, s 1- 10
  • Terje P. Hagen; Geir Hiller Holom & Kebebew Negera Ameyu (2017). Outsourcing day surgery to private for-profit hospitals: the price effects of competitive tendering. Health Economics, Policy and Law.  ISSN 1744-1331.  13, s 50- 67
  • Nina Alexandersen; Terje P. Hagen & Oddvar Martin Kaarbøe (2017). Hvilke bedrifter kjøper private helseforsikringer i Norge?. Samfunnsøkonomen.  ISSN 1890-5250.  1, s 31- 38
  • Geir Hiller Holom & Terje P. Hagen (2017). Quality differences between private for-profit, private non-profit and public hospitals in Norway: a retrospective national register based study of acute readmission rates following total hip and knee arthroplasty. BMJ Open.  ISSN 2044-6055.
  • Nina Alexandersen; Anders Anell; Oddvar Martin Kaarbøe; Juhani S. Lehto; Liina-Kaisa Tynkkynen & Karsten Vrangbæk (2016). The development of voluntary private health insurance in the Nordic countries. Nordic Journal of Health Economics.  ISSN 1892-9729.  4, s 68- 83

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  • Terje P. Hagen (2018). Privatisering av helsetjenester i Norden - hovedkonklusjoner.
  • Karsten Vrangbæk (2018). Private sundhedsforsikringer og private sygehuse i Danmark.
  • Juhani S. Lehto & Terje P. Hagen (2018). HEALTH AND SOCIAL CARE SYSTEM REFORM IN FINLAND perspectives on private insurance and private hospitals.
  • Geir Hiller Holom (2018). Hvem benytter private kommersielle sykehus.
  • Oddvar Martin Kaarbøe (2018). Hva kjennetegner bedrifter som kjøper private helseforsikringer i Norge.
  • Karsten Vrangbæk (2018). Litteraturreview - er private sygehuse mere effektive end offentlige.
  • Terje P. Hagen (2017). Privatisering på norsk. Anbudskonkurranser, seleksjon og kvalitet i en skattefinansiert helsetjeneste..
  • Geir Hiller Holom; Nina Alexandersen & Terje P. Hagen (2017). Which patients receive surgery in for-profit and non-profit hospitals in a universal Health system? An explorative register-based study.
  • Liina-Kaisa Tynkkynen; Nina Alexandersen; Oddvar Martin Kaarbøe; Anders Anell; Juhani S. Lehto & Karsten Vrangbaek (2017). Development of Voluntary Private Health Insurance in Nordic Countries – An Exploratory Study on Country-specific Contextual Factors.
  • Oddvar Martin Kaarbøe (2017). Location choice and quality competition in mixed hospital markets.
  • Burkhard Hehenkamp & Oddvar Martin Kaarbøe (2017). Location Choice and Quality Competition in Mixed Hospital Markets.
  • Oddvar Martin Kaarbøe (2016). Hvilke bedrifter kjøper private helseforsikringer i Norge?.
  • Geir Hiller Holom (2016). Patient selection in private for-profit, private non-profit, and public hospitals using Norwegian big data.
  • Nina Alexandersen; Terje P. Hagen & Oddvar Martin Kaarbøe (2016). Hvilke bedrifter kjøper private helseforsikringer i Norge?.
  • Oddvar Martin Kaarbøe (2016). Location choice and quality competition in mixed hospital markets.
  • Geir Hiller Holom (2016). Big Data in Norway.
  • Geir Hiller Holom (2016). Which Patients Receive Surgery in For-Profit and Non-Profit Hospitals in a Universal Health System?.
  • Oddvar Martin Kaarbøe (2016). Location Choice and Quality Competition in Mixed Hospital Markets.
  • Oddvar Martin Kaarbøe (2016). Privata sjukvårdsförsäkringar i Norden – vilka är köparna och vilka effekter får dom?.
  • Oddvar Martin Kaarbøe; Terje P. Hagen & Nina Aleksandersen (2016). Hvilke bedrifter kjøper private helseforsikringer i Norge?.
  • Oddvar Martin Kaarbøe (2015). Location choice and quality competition in mixed hospital markets.
  • Oddvar Martin Kaarbøe (2015). Location choice and quality competition in mixed hospital markets.

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Published Mar. 7, 2019 12:03 PM - Last modified Mar. 7, 2019 12:14 PM