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Regulated competition and citizen participation

Lessons from Israel

Bibliographic Data

ID19507620
AuthorsDavid Chinitz (0000-0001-8000-9678, Hebrew University of Jerusalem, corresponding author)
Year2000
Volume3
Issue2
Pages90-96
Publication date2000-06-01
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1046/j.1369-6513.2000.00065.x
PMID11281916
OpenAlexW2062007360
LanguageEN
Citations received1
References cited8

OBJECTIVE: To investigate the relationship between health system structure and citizen participation, in particular whether increased reliance on competition encourages or depresses citizen involvement. SETTING: The case of Israel's ongoing health reform, based on regulated competition among sick funds, is examined. DESIGN: Interviews with government officials and representatives of consumer groups; analysis of policy documents, judicial rulings, public surveys and journalistic accounts. RESULTS: The Israeli reform is based in large measure on a regulated competition model, in which citizens have free choice among highly regulated competing sick funds. At the same time, the reform process has been accompanied by legal, institutional and political frameworks, as well as significant interest group activity, all aimed at increasing public input into processes of health policy making and implementation. The Israeli case, it is argued, lends support to the proposition that citizen participation (voice) and individual choice (exit) are complementary, rather than alternative, modes of ensuring citizen influence over health services. The question is whether the development of multiple avenues for citizen involvement represents disarray or a healthy social learning process regarding the running of the health system. CONCLUSION: This paper expresses cautious optimism that citizen participation is a projection of a healthy social learning process, and suggests directions for public policy to encourage this outcome

Economics · Optimism · Political science · Politics · Proposition · Public economics · Public relations · Global Public Health Policies and Epidemiology · Healthcare Policy and Management · Law · Pharmaceutical industry and healthcare · Psychology · Public Administration · Social Psychology

  • Consumer choice of social health insurance in managed competition

    Open Access•Jan J Kerssens, Peter P Groenewegen et al.•Health Expectations•2003

  • Lay Participation in Health Care Decision Making

    Cathy Charles, Suzanne DeMaio et al.•Journal of Health Politics Policy…•1993

  • Voice, Choice and the Question of CMI Democracy in the Swedish Welfare State

    Open Access•Richard B Saltman, Casten von Ofter•Economic and Industrial Democracy•1989

  • Economic Models in Political Science

    Open Access•A H Birch•British Journal of Political…•1975

Citations per year0.04
Citation span2003 - 2003 (1)
Highly citedNo

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