Health Systems: Private or Public?

Abstract

The immediate impact of the coronavirus crisis on individual well-being depends on the ability of the health system to deal with the pandemic. Countries differed widely with regard to the qualification of their health system. From a Political Economy perspective, a core question is whether a national health system should be predominantly private or public. The fate of different national health systems has demonstrated that public health systems generally fare better than private systems with the fight against pandemics, if we control for expenditure levels. Moreover, well-funded public health (and social policy) systems also provided a better protection during the pandemic than health systems with massive funding constraints, for example due to austerity policies. Correspondingly, there is a certain likelihood that the tendency towards privatization of health systems that has begun during the 1980s will be reversed and many public health systems will be better funded in the future. Finally, the experience with autonomous science-focused health agencies during the pandemic clearly indicates the primacy of politics in a situation of national emergency.