Market Within the Monopoly: The National Health Service Hospital Trust
Ernzen, William F.
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In 1994, debate on health care dominated the American political agenda. The contention over proposals presented by President Clinton and certain members of congress displayed the many complex factors surrounding this extremely important issue. At the end of 1994 however, health care reform in the United States was removed from the immediate political agenda when consensus could not be reached. Health care provision presents a major challenge not only to the United States, but to all nations. A multitude of different structures exist as each country attempts to provide the best possible care to the largest number of people at the lowest cost. Each of these structures operates contingent on the socio-economic factors which exist in each respective country, often making comparison difficult. These structures can, however, allow us to analyze different options for the provision of health care in other parts of the world. England provides health care to its residents through a National Health Service. In the past few years, however, the management structure within the service has changed, creating a unique economic structure, an internal market within a nationally controlled monopoly. Part Two of this paper presents a description and analysis of this structure. The provision of health care requires a multitude of inputs, many of which come from medical supply companies. Knowledge of the marketing strategies of medical suppliers allow insights into the operations of a health care marketplace. The marketing operations of Stryker UK, a company which supplies to the United Kingdom's health care market, are presented in Part Three. Part IV analyzes the process of marketing to the internal market. The market dynamics presented in Part Two will be combined with the marketing procedures and strategies of Part Three to analyze the interrelationship between marketing and the market. Part Five will offer a brief conclusion as to the significance of this structure for the global health care crisis.