Regulating Healthcare: A Prescription for Improvement?

Kieran Walshe Open University Press, 2003; 0-33-521023-6; 192 pp; 112. 95 Hb, 37. 95 Pb The USA is as close to a market-based health care economy as you will find in any developed country. The UK is more or less as close to a wholly state-funded and -provided health care system as can be found in the developed world. Nevertheless, two observations apply across the two countries’ health care systems. Firstly, the systems are characterized by an extraordinary degree of regulation, and secondly, quality-of-care problems are quite prevalent in both countries. These two observations serve as the basis for a new book by Professor Kieran Walshe that addresses one of the fundamental questions facing the US and UK health care systems: does greater regulation improve the quality of care? This is not a straightforward question for several reasons. Firstly, health care regulations are quite diverse along several dimensions. Secondly, the underlying rationale for health care regulation is not always to improve performance, i. e. regulations may exist to serve the interests of the regulator or various provider groups. Thirdly, there is not a standard method for evaluating regulatory performance, especially in light of the disparate forms of regulation present in the health care sector. And finally, there is often very little empirical work linking the costs and benefits of regulation. Professor Walshe considers all of these issues in analyzing the …