The health care market: what possible competition?

The subject of competition in health care exceeds the scientific journals being discussed in almost each public debate on the health care system. In this paper the elements characterising economic competition will be defined in comparison with the particular characteristics of the health care market. The peculiar features of that market require attention to be paid to the equity of the system, to the competitive mechanisms which are not completely evaluated and to the failures of the public bureaucracy still operating. The principal models of competition found in the literature are illustrated and some experiences as UK and Sweden are shown. Some elements of competition are proposed for the Italian National Health Service (INHS) with some rules for the possible implementation.