OECD Health Working Papers

1815-2015 (online)
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This series is designed to make available to a wider readership health studies prepared for use within the OECD. Authorship is usually collective, but principal writers are named. The papers are generally available only in their original language - English or French - with a summary in the other.

Pricing and competition in Specialist Medical Services

An Overview for South Africa You or your institution have access to this content

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Ankit Kumar1, Grégoire de Lagasnerie, Frederica Maiorano, Alessia Forti1
Author Affiliations
  • 1: OECD, France

12 June 2014
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Major disparities in the cost of health care have made the pricing of specialist and hospital services a contentious issue in South Africa, particularly in the private sector. To help inform policy debate, this paper profiles selected experiences on the pricing of health services, competition policy and models of buying specialist health care services from the private sector across the OECD. Firstly, South Africa is compared to OECD countries to identify countries where voluntary private health insurance – the major source of financing for private hospitals – plays a similar role. Second, this paper provides an overview of price setting across OECD health care systems. It then covers the economic rationale and the institutional arrangements which OECD countries have established to set prices, before moving to an overview of competition policy considerations surrounding these arrangements. Finally, the paper highlights a few models of buying services from the private sector for public patients, with a particular focus on Mexico and Turkey. It is argued that South Africa should separate the task of establishing a schedule of medical services from negotiations over overall payments to medical professionals.
JEL Classification:
  • I1: Health, Education, and Welfare / Health
  • I11: Health, Education, and Welfare / Health / Analysis of Health Care Markets
  • I18: Health, Education, and Welfare / Health / Government Policy ; Regulation ; Public Health
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