For-profit Hospitals: A comparative and longitudinal study of the for-profit hospital sector in four Western countries

Many now argue that for-profit hospital ownership is on the rise because of the retrenchment of public entitlements and – often more importantly in health care – pro-market reforms in the delivery of these services1. Most theoretical notions assume that for-profit hospitals are more efficient than nonprofit and public hospitals2. It is thought that the inclusion of for-profits in the mainstream health care delivery system may increase efficiency or lower costs3. Issues and ideas around ownership are central in the public arena and for-profit hospital care has thus become the subject of fierce debate. Much of this discourse centers on the question whether health care differs fundamentally from other services, and should thus be sheltered from market forces4. Opponents of for-profit hospitals fear restricted access for those unable to pay, lower quality of care, cherry-picking of profitable services and patients, and excessive management interference in clinical autonomy. Proponents, on the other hand, believe that for-profits can bring about higher levels of efficiency and are more responsive to patient demands.

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