Financialisation in health care: An analysis of private equity fund investments in Turkey

Vural, İpek Eren

doi:10.1016/j.socscimed.2017.06.008

Cited by 31 publications

(21 citation statements)

References 19 publications

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“…Three studies analysed conflict of interests between corporations’ investments and CSR initiatives,36 accountability of partnerships,71 and human rights abuses in funded programmes 72. The financialisation of global health (ie, the increase in size and influence of financial institutions and markets) introduces new ethical challenges spurred by financial motives,73 such as conflicts of interest between global health foundations and food and pharmaceutical corporations,10 ‘responsible banking’ of the financial sector investing in global health,74 and equitable access to private healthcare 75. Ethical concerns in global mental health are often limited to conflict of interests in practitioners,76 while a systemic approach to ethical financing is lacking.…”

Section: Discussionmentioning

confidence: 99%

Sustainable development for global mental health: a typology and systematic evidence mapping of external actors in low-income and middle-income countries

Iemmi

2019

BMJ Glob Health

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IntroductionMental disorders account for a substantial burden of disease and costs in low-income and middle-income countries (LMICs), but attract few resources. With LMIC governments often under economic pressure, an understanding of the external funding landscape is urgently needed. This study develops a new typology of external actors in global health adapted for the sustainable development goals (SDGs) era and uses it to systematically map available evidence on external actors in global mental health.MethodsThe new typology was developed in line with conceptualisation in the literature and the SDGs to include 11 types of external actors for health in LMICs. Five databases (EconLit, Embase, Global Health, MEDLINE, PsycINFO) were searched for manuscripts published in peer-reviewed journals in English, French, Italian, Portuguese or Spanish between 1 January 2000 and 31 July 2018 and reporting information on external actors for mental disorders in LMICs. Records were screened by abstract, then full-text against inclusion criteria. Data were extracted and synthesised using narrative analysis.Results79 studies were included in the final review. Five were quantitative studies analysing the resource flow of development assistance for mental health globally over the last two decades. The remainder were qualitative studies providing a description of external actors: the majority of them were published in the last decade, focused on Africa, and on public sector (bilateral and multilateral governmental organisations) and third sector organisations (non-governmental organisations). Evidence was particularly scarce for for-profit organisations and individual households.ConclusionThis study reveals opportunities for unlocking additional funding for global mental health in the SDG-era from an ecosystem of external actors, and highlights the need to coordinate efforts and to use sustainable, ethical approaches to disbursements. Further research is needed to understand all external actors and the allocation of their contributions in different settings.

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Section: Discussionmentioning

confidence: 99%

Sustainable development for global mental health: a typology and systematic evidence mapping of external actors in low-income and middle-income countries

Iemmi

2019

BMJ Glob Health

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“…Healthcare companies are pursuing acquisitions and fast rates of growth in the number of facilities to increase company value. In Turkey this has led to rapid expansion and concentration in the private healthcare sector (Eren Vural, ), and other commentators have pointed to similar trends for concentration in India (Chakravarthi et al., ) and South Africa (Munyai, ) — countries that have been the focus of ‘leveraging’ efforts by development finance institutions. The search for new markets has also encouraged transnational activity, and middle‐income countries in Eastern and Western Africa are attracting particular attention (Mohandas, ).…”

Section: Societal and Health Effects Of ‘Investing In Health’mentioning

confidence: 92%

“…Relatively little research has been done so far on the practicalities of financialization in healthcare provision. Two exceptions, Bayliss () and Eren Vural (), have analysed processes, actors and sectoral effects in England and Turkey, respectively, demonstrating the value of detailed national analysis. They show deepening inequities, spiralling costs and market concentration.…”

Section: Financialization and Developmentmentioning

confidence: 99%

“…Private healthcare companies burgeoned in India, for example, after the federal government lifted national restrictions on foreign direct investment in hospitals in 2000, while the loosening of restrictions on foreign ownership of hospitals in China during the 12th and 13th five‐year plan periods offered similar in‐roads. In Turkey, a Health Transformation Plan launched in 2003 introduced a purchaser–provider split and mechanisms for public contracting of private providers, enabling that sector to grow and consolidate (Eren Vural, ; Yilmaz, ).…”

Section: The Groundwork Of Commercialization In Healthcarementioning

confidence: 99%

“…In Turkey, the Justice and Development Party's Health Transformation Programme, supported by the World Bank, appealed simultaneously to the urban poor and private hospital owners by expanding public health insurance to allow purchasing of services from private healthcare providers (Yilmaz, ). In so doing it stimulated rapid expansion in investment and capacity in private healthcare provision, and subsequent market concentration (Eren Vural, ). More recently, the national government's programme to construct 25 ‘health campuses’ using private finance initiatives (lenders include EBRD, IFC, OPIC and a suite of private organizations) speaks less to the commercial interests of private healthcare providers and more to those of investment, real estate, construction and medical technology industries.…”

Section: ‘Partnership Capital’ and The Institutional Arrangements Formentioning

confidence: 99%

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Deconstructing the Financialization of Healthcare

Hunter¹,

Murray²

2019

Development and Change

121

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Financialization is promoted by alliances of multilateral 'development' organizations, national governments and owners and institutions of private capital. In the healthcare sector, the leveraging of private sources of finance is widely argued as necessary to achieve the Sustainable Development Goal 3 target of universal health coverage. Employing social science perspectives on financialization, the authors of this article contend that this is a new phase of capital formation. The article traces the antecedents, institutions, instruments and ideas that facilitated the penetration of private capital in this sector, and the emergence of new asset classes that distinguish it. The authors argue that this deepening of financialization represents a fundamental shift in the organizing principles for healthcare systems, with negative implications for health and equality.

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