Why the views of middle class citizens help explain increased choice in European healthcare systems

Several countries across Europe have attempted to reform their health systems by allowing patients more choice over their healthcare provider. The typical rationale for this strategy is that by creating competition between providers, there will be an increased incentive to improve the efficiency and quality of healthcare. Joan Costa-i-Font and Valentina Zigante assess the underlying factors that have led to European countries adopting this ‘choice agenda’ in their healthcare systems. They find that one of the key drivers for this type of reform has been the role of middle class citizens in demanding greater choice over health providers.