Market competition: everybody is talking, but what do they say?. A sociological analysis of market competition in policy networks.
From providers and insurers to governments and consumers, it appears that everybody is talking about market competition in health care. However, what do they actually mean? Are they talking about the same things? These questions are relevant for health systems consisting of policy networks, such as in the Netherlands. In policy networks, different actors (besides the government) are engaged in policy-making. Based on their particular frame ('mode of interpretation'), actors proceed and, from this, give meaning to the concept of market competition. Since there are differences in frames (of reference) among the various actors, it is important to understand what market competition means from the perspective of each network participant. This study, with regard to the Dutch health care system, demonstrates 'market competition' as a broad concept, relating to 13 different frames. Only four frames (i.e. cost control, deregulation, competition and increased power) are shared by a maximum of two (out of a total of four) network participants. Clearly, there are differences in the meanings and underlying frames about market competition amongst the key players. The resulting implications and options for policy-making are discussed.
Paulus
Aggie
A
Department of Health, Organisation, Policy and Economics (HOPE), Faculty of Health Sciences, University of Maastricht, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. a.paulus@beoz.unimaas.nl
van Raak
Arno
A
van der Made
Jan
J
Mur-Veeman
Ingrid
I
D003255:Consumer Organizations; D004465:Economic Competition; D005381:Financing, Organized; D006076:Government; D019981:Health Care Sector / Q000458:organization & administration*; D006291:Health Policy / Q000191:economics*; D007373:Interinstitutional Relations; D009313:National Health Programs / Q000191:economics*; D009426:Netherlands; D011050:Policy Making; D017149:Private Sector; D017150:Public Sector