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On the Fuzzy Boundaries between Public and Private in Health-Care Organization and Funding Systems

Alessandro Petretto*,
University of Florence


The paper proposes a theoretical survey of health-care organization and funding systems, by underlining and discussing the combination public versus private provision and production of social assistance services. The survey then examines the present features of various National health services, focusing on the efficiency and equity of public intervention and on the industrial organization of the institutional design of health care. Hence, the paper treats the cost-benefit of vertical integration of structures, devoted respectively to purchasing and providing health-care services, it considers the effects of managed competition in quasi-markets and, finally, it deals with supplementary insurance systems.

[JEL Classification: I1; H1; H4].

Keywords: health-care organization; health-care funding; social insurance; private and public provision.


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*"alessandro.petretto@unifi.it", Department of Social Sciences. Paper presented at the Special session "Markets and institutions", of 7th Congress of the Italian Association for the History of Political Economy (STOREP), The Shifting Boundaries between Public and Private in Economics, Trent May 30th - June 1st 2010. I thank all the participants to the session for the helpful discussion. I also thank the anonymous referees for their valuable comments and suggestions.
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