PRIVATE PARTICIPATION IN THE MANAGEMENT OF PUBLIC HEALTH CARE

Abstract

The article analyzes contracts between the public health system and private providers. Specifically; it examines the private sector’s participation in the public health system and how the latter uses contractual mechanisms to incorporate private providers; a trend that is gaining ground internationally. There are two major trends in contract design. The first creates market conditions in the provision of health care under which private players compete with public entities for the same resources. Under the second; private providers are viewed as collaborators of the public sector and contracts serve as mechanisms for articulating a health care network. The article shows that the second trend is found in Chile. It argues that the agreements reached by health services and their dependent bodies have tended to create a kind of quasi-market in health care. At the same time; it analyzes how contracts signed by the National Health Care Fund (FONASA) have articulated a public-private network with positive results.