| Abstract: | The emergence of the privatization of health care services as one of the dominant health policy issues in many western industrialized countries is no doubt related to a number of factors, including rising health care costs, fiscal crisis in the form of budgetary deficits, charges of public waste and mismanagement and underfunding, the onset of a new era of political and fiscal conservatism, and professional and corporate antipathy to certain aspects of publicly financed health insurance schemes. The paper discusses the meaning of privatization and stresses the importance of recognizing the different forms of privatization and the need to assess these forms against well specified health policy objectives. Current and proposed forms of privatization in Canada are described and evaluated. It is concluded that there are sound arguments against privatization through user fees for insured physician and hospital services. As for the other forms of privatization there are confusing and inconsistent findings that preclude a definitive conclusion as to the wisdom of a general push for privatization. It is stressed that there are not many empirically established facts about the likely effects of privatization and the many claims about the virtues of privatization are far from substantiated by careful research. In the absence of such evidence the push for reprivatization seems, as some critics have pointed out, ideologically motivated. |
