Outsourcing Public Services: Ownership, Competition, Quality and Contracting

We survey the literature on the effects of public sector outsourcing. Guided by theory, we systematically arrange services according to the type and magnitude of their contractibility problems. Taken as a whole, the empirical literature indicates that public sector outsourcing generally reduces costs without hurting quality. This is clearly the case for “perfectly contractible services” like garbage collection, but outsourcing often seems to work reasonably well also for some services with more difficult contracting problems, e.g. fire protection and prisons. Outsourcing seems to be more problematic for credence goods, with residential youth care as the prime example. In contrast to previous reviews, we conclude that ownership and competition appear to be about equally important for the consequences of public sector outsourcing.Outsourcing; Contracts; Tendering; Ownership; Competition; Quality

The Financial and Operating Performance of Privatized Firms in Sweden

This paper examines the change in operating and financial performance of Swedish firms that were either partly or fully privatized during the period of 1989-2007. Two different methods are used to empirically investigate the performance of privatized firms. First, accounting data prior to and after the privatization are employed to measure the operating performance of privatized firms. We have found no significant difference in performances under state and private ownerships. Second, a return-based event study is found useful to measure the financial performance of privatized firms, since all the firms in the sample that were privatized have used an initial public offering (IPO). This approach allows comparison to the rest of the IPOs that were launched in the same period. It is found that the cumulative returns for the privatized firms are significantly different to private counterparts. Overall results, however, show that the privatization in Sweden was not as successful as it might have been expected and in comparison with those in other countries.Sweden, efficiency, performance measure, privatization, ratio analysis, event-study, public and private relationship

Ownership, Incentives and Hospitals

This article analyzes hospital privatization by comparing costs and quality between different ownership forms. We put the attention on the distinction between public hospitals and private hospitals with public funding. Using information about Spanish hospitals, we have found that private hospitals provide services at a lower cost at expenses of lower quality. We observe that property rights theory is fulfilled at least for the Spanish hospital market. The way that Heath Authorities finance publicly funded hospitals may be responsible for the differences in incentives between public and private centers. We argue that the trade-off between costs and quality could be minimized by designing financing contracts with fixed and variable components.Privatization, Hospitals, Costs, Quality. JEL classification:I11; L15; L33

Ownership, Incentives and Hospitals

This article analyzes hospital privatization by comparing costs and quality between different ownership forms. We put the attention on the distinction between public hospitals and private hospitals with public funding. Using information about Spanish hospitals, we have found that private hospitals provide services at a lower cost at expenses of lower quality. We observe that property rights theory is fulfilled at least for the Spanish hospital market. The way that Heath Authorities finance publicly funded hospitals may be responsible for the differences in incentives between public and private centers. We argue that the trade-off between costs and quality could be minimized by designing financing contracts with fixed and variable components

Financialisation and Public Health Systems: a new concept to examine ongoing reforms

Public Health Systems (PHS) are in constant evolution. Research in the field must be continuously updated considering the direction of these changes. The present stage of capitalism is underpinned by the process of financialisation – the expansion of the financial sector in size, scale, and power. Although the process of financialisation is reshaping PHS, the mechanisms through which this occurs remain poorly investigated. This article aims to discuss how the concept of financialisation can be incorporated into the conceptual framework currently used to examine PHS reforms. This allows us to understand better the drivers, features, and impacts of recent policy shifts. In light of the potential of financialized strategies to grow as a new solution for financially strained systems, refining the concepts used in PHS research represents a crucial avenue of investigation.Les systèmes de santé publique (SSP) sont en constante évolution. La recherche dans ce domaine doit être continuellement mise à jour en tenant compte de l'orientation de ces changements. Le capitalisme contemporain est sous-tendu par le processus de financiarisation - l'expansion du secteur financier en taille, échelle et pouvoir. Bien que le processus de financiarisation remodèle les SSP, les mécanismes par lesquels cela se produit restent peu étudiés. L'objectif de cet article est d'examiner comment le concept de financiarisation peut être intégré dans le cadre conceptuel actuellement utilisé pour examiner les réformes des SSP. Cela nous permet de mieux comprendre les moteurs, les caractéristiques et les impacts des changements de politique ciblant ces systèmes. Compte tenu du potentiel de croissance des stratégies financiarisées en tant que nouvelle solution pour des systèmes de santé financièrement fragiles, il est essentiel de bien préciser les concepts utilisés dans la recherche sur ces systèmes

Labor, Business, and Change in Germany and the United States

The chapters explore the proposition that the benefits of either the German coordinating institutions or the United States\u27 more decentralized political economy each entail trade-offs that may be necessary but politically unpleasant. The authors also offer comparisons of sectoral and firm-level adjustment processes for change.https://research.upjohn.org/up_press/1181/thumbnail.jp