Competition in health markets: is something rotten?

Defensive medicine in Europe: a ‘full circle’?

“…Healthcare is a classical example of 'market failure' in economic theory, since health is a 'merit good' rather than a common 'consumer good' [49]. Therefore, competition is not the best instrument for addressing equity concerns, and an 'Americanization' of health, with high prevalence of private for-profit 'players' (for both funding and provision), is hardly recommendable: not by chance has the USA skyrocketing healthcare expenditure and spends far more than other wealthy nations for administration [50]. Differently, in the European health systems patients have not been historically considered common consumers, and physicians respond mainly to 'third-party payers' for healthcare expenditure.…”

“…The most worrying recent institutional trend in Europe has been the widespread adoption of tariffs instead of global budgets for funding healthcare services. This arguable choice one more 'Americanization' can eventually undermine coordination and synergies among health services [50]. In particular, we share the opinion that fee-for-service systems tending to reward over treatments can eventually induce DM as a further potential distortion [40], so they should be ruled out.…”

Conflict of interest disclosure: striking a balance?

“…We finally selected 73 studies [4]. The majority of publications (> 70%) come from the US, probably not by chance, since the American health system has the highest prevalence of private 'players' (both for funding and provision) among highly developed countries [34], and health care expenditure is permanently out of control [35]. Last but not least, many American companies of pharmaceuticals and medical devices are big and profitable.…”

The Italian NHS: What Lessons to Draw from COVID-19?

“…Another crucial issue for Italian AEs is that they are located in many public hospitals that are of a small sizearound 30% with < 120 beds, and only 15% with > 600 beds [1]. Many efforts to make public hospital networks more rational have failed, eventually leading to questionable reorganizations at local level [11]. For instance, the two AEs in which the first and second outbreaks started in Lombardy are both located in very small hospitals.…”