Paradigms of Healthcare Systems, Law, and Regulation: A Transatlantic Conversation

This chapter assesses how the law creates and sustains healthcare systems. It considers six paradigm concepts which are important in the structures of healthcare systems and how the law seeks to support and encourage the effective provision of healthcare to relevant populations. These concepts are quality/accessibility; health citizenship and a “right to health”; individual liberty; market competition; economic productivity; and “health justice” and integrated social services. The chapter then discusses five structures for health system regulation, starting with the simplest: public provision of health services, publicly funded but privately supplied health services, self-regulating health professions, public– private partnerships, and nonprofit and charitable organizations. Finally, it compares European and American approaches to the geographical dimensions of health system law and regulation, discussing paradigms of federalism and localism.