Toward a new conceptualization of health care services to inspire public health. Public national health service as a “common pool of resources”

Abstract

The recent financial crisis weakened Western economies, disclosing their frailties and exerting a strong pressure on the sustainability of their welfare systems. Among others, publicly-funded national health systems, a cornerstone of the “welfare state model” in most of European countries, face a hard period, tightened in the stranglehold between scarce resources and increasing health needs. This paper conceives health services provided by publicly-funded national health systems as “non-excludable”, but “rival” goods. Drawing on this interpretation, publicly-funded national health systems are understood as “common pools of resources”. A theoretical standpoint is adopted to discuss this topic. The article proposes general reasoning and basic remarks, deferring to further developments empirical applications. The paper contributes to the scientific literature by offering a new perspective from which the functioning of publicly-funded national health systems could be investigated. The “Common Pool Resources” theory and the “Institutional Analysis and Development” framework are proposed as key tools to inspire public health policies. They allow to examine in-depth the sustainability issues of publicly-funded national health systems, paving the way for innovative approaches in health care management and marketing.