Actors and Motives in the Internationalization of Health Businesses

The increasing trend towards the internationalization of the world economy coupled with the liberalizing agenda of international institutions and Western governments has profound implications for the delivery of health and other welfare services. As governments pursue policies which extend the scope for the involvement of private companies in the delivery of welfare services, processes of internationalization are likely to become increasingly important to such services as multinational providers emerge. This article begins the process of developing a systematic understanding of the relationships between the structure of welfare states, the social and economic policies of governments and international institutions, and the strategies and interests of private companies. It is argued that it is the particular mix of direct state provision, tax/subsidy, and regulation in the welfare state formation that provides the opportunities for, or barriers to, the expansion of internationalizing private providers of healthcare. This argument is illustrated through a case study of the current process of reform in the British healthcare system, where a relative shift away from direct state provision towards subsidizing and regulating private providers is facilitating a process of internationalization.