This chapter unveils healthcare through the perspective of negotiation, the dominant yet hidden force in healthcare. Step by step, it explains how the different types of healthcare systems were created and then shaped by negotiation power and tensions. It identifies the players in healthcare, the negotiation tensions between them, their sources of power, and the implications of these tensions. It guides the reader through how they historically shaped the different types of healthcare financing and management (via Sick Funds, Government, Market-driven, out-of-pocket, and combinations of them) and is a key driver to understanding them. Finally, the authors guide us through the two key negotiation strategies (win-win/collaborative vs. win-lose/competitive), highlighting how misunderstood these strategies are and how and why the competitive strategy is by far the most widespread and a root cause for so many problems. At the end of this chapter, the reader will have gained a new outlook on healthcare financing and management and understand how negotiation shapes healthcare.

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Understanding Healthcare Systems and Their Negotiations

  • Horacio Falcão,
  • Rodrigo Gouveia,
  • Hervé Lamarque

摘要

This chapter unveils healthcare through the perspective of negotiation, the dominant yet hidden force in healthcare. Step by step, it explains how the different types of healthcare systems were created and then shaped by negotiation power and tensions. It identifies the players in healthcare, the negotiation tensions between them, their sources of power, and the implications of these tensions. It guides the reader through how they historically shaped the different types of healthcare financing and management (via Sick Funds, Government, Market-driven, out-of-pocket, and combinations of them) and is a key driver to understanding them. Finally, the authors guide us through the two key negotiation strategies (win-win/collaborative vs. win-lose/competitive), highlighting how misunderstood these strategies are and how and why the competitive strategy is by far the most widespread and a root cause for so many problems. At the end of this chapter, the reader will have gained a new outlook on healthcare financing and management and understand how negotiation shapes healthcare.