Globalisation and commercialisation of healthcare services: with reference to the United States and United Kingdom

Drymoussis, Michael (2014) Globalisation and commercialisation of healthcare services: with reference to the United States and United Kingdom. Doctoral thesis (PhD), University of Sussex.

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Abstract

The thesis seeks to interrogate historically the relationship between multinational healthcare
service companies and states in the pursuit of market-oriented reforms for healthcare. It
constitutes a critical reading of the idea of globalisation as a concept with substantive
explanatory value to analyse the causal role of multinational service firms in a commercial
transformation in national healthcare service sectors. It analyses the development and expansion
of commercial (for-profit) healthcare service provision and financing in the healthcare systems
of OECD countries. The hospital and health insurance sectors in the US and UK are analysed as
case studies towards developing this critical reading from a more specific national setting.

The thesis contributes to developing a framework for analysing the emergence of an
international market for trade in healthcare services, which is a recently emerging area of
research in the social sciences. As such, it uses an interdisciplinary approach, utilising insights
from health policy and international political economy. The research entails a longitudinal study
of secondary and primary sources of qualitative data broadly covering the period 1975-2005. I
have also made extensive use of quantitative data to illustrate key economic trends that are
relevant to the changes in the particular healthcare services sectors analysed.

The research finds a substantive shift in the mixed economy of healthcare in which commercial
healthcare service provision and financing are increasing. However, while the
internationalisation of healthcare service firms is a key element in helping to drive some of this
change, the changes are ultimately highly dependent on state-level decision making and
regulation. In this context, the thesis argues that globalisation presents an inadequate and
potentially misleading conceptual framework for analysing these changes without a historical
grounding in the particular developments of national and international markets for healthcare
services.

Item Type: Thesis (Doctoral)
Schools and Departments: School of Law, Politics and Sociology > Sociology
Subjects: R Medicine > RA Public aspects of medicine > RA0001 Medicine and the state. Including medical statistics, medical economics, provisions for medical care, medical sociology
Depositing User: Library Cataloguing
Date Deposited: 14 Jun 2016 11:19
Last Modified: 14 Jun 2016 11:19
URI: http://sro.sussex.ac.uk/id/eprint/61483

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