The proper role of public versus private health care financing

As part of HEPL’s 10th anniversary edition I was asked to comment on an excellent paper by Tinghog and colleagues that explored what parts of health care are suitable for private financing. In doing so, I turned the idea around as I believe many countries need to clarify the role and scope of the publicly financed portion of the health care system. That is, we must clearly define what the public benefit will cover and for whom. In the absence of such streamlining the health care system cannot be expected to achieve its goals, and the private system cannot step into an optimally helpful supplementary role. Knowing what health care was used to be easier. Care performed in hospitals or by doctors was considered to be a core benefit available for all. If a doctor didn’t do it, it wasn’t medicine. The task is considerably more difficult now.