Political Determinants of Health:Health Care Privatization andPopulation Health in Europe

Context:The extent to which health care reforms affect health remains understudied. Health carereforms result in policy outputs that determine provision of medical services, which have con-sequences for the health of the population. The authors scrutinize this relationship between healthpolicy outputs and population health by focusing on legislative changes implying privatization ofhealth care delivery and finance. They ask the following question: What is the relationship betweenreforms that privatize health care provision and population health in terms of health outcomes andinequalities?Methods:They answer this question by relying on fixed-effects time-series cross-section models.The authors use an original dataset of health care reforms passed in 36 European countries from1989 to 2019. Health outcomes are operationalized with measures of subjective health status,unmet health needs, and resulting health inequalities.Findings:Their results show that privatization of health care is associated with higher rates of badsubjective health and unmet health needs several years after the passing of reforms. These effectsare stronger for individuals in the lower tiers of income and education, resulting in greater socio-economic inequalities.Conclusions:The article contributes to conceptualization of the political determinants of health ashealth policy outputs and a better understanding of the relationship between policy outputs andpopulation health outcomes