Managed Competition in Health Care

A variety of ‘managed competition’ arrangements covering the financing, purchasing and delivery of health care services operate in a number of countries, such as the United States, the Netherlands and Israel. Drawing on these models, health economist Dr Richard Scotton has developed a managed competition proposal as a means of addressing perceived shortcomings in Australia’s health system. His model has attracted growing interest.

In recognition of this, the Commission arranged a Workshop on Managed Competition in Health Care to provide an opportunity for a more detailed discussion of the Scotton proposal by a group of leading health policy analysts.

The Workshop featured four sessions covering a description and review of the Scotton proposal, the payment framework for programs and services, implementation issues and potential outcomes of the proposal in terms of dealing with a number of specific problems in our health system.

The proceedings include introductory comments from Richard Scotton on each session, comments from Ron Donato of the University of South Australia on payment-related issues and summaries of the general discussion in each session. They also include a summary of the views of participants and alternative proposals for more incremental change.