The internalization context of private health service providers in Europe: Romanian market case study

This paper looks at the opportunities and constraints of the private healthcare sector in Europe today. Using the case study of Romania, I explore the attractiveness of foreign and domestic private capital investments in companies that supply healthcare services. In the aftermath of the economic crisis, the private provision of healthcare services has been growing steadily, and there are clear signs in the common market that the liberalisation policies will only increase the attractiveness of such investment still. As large-scale investment projects like general hospitals require large amounts of upfront investment, it is only natural to assume that at least part of this capital will be obtained through internationalisation decision of foreign companies. This paper also presents in depth a comparative overview of the two most developed private healthcare provisions in Romania: dialysis centres and medical laboratories. Part of their success is due to their longstanding relationship with the National Health Insurances House. These medical services generally benefit from large scale public subsidies that support the delivery of private health care provision in Romania. The private providers of medical services in Romania have recorded a steady annual growth dynamics over the past years. In the case of private medical laboratories, the geographical distribution shows a heavy concentration on the main municipalities in Romania. This gives us a perspective on the limited ability of private providers to penetrate smaller markets without the incentive of public subsidies. The Romanian market has proved to be an attractive destination for foreign investors in the medical sector. This is driven in part by the quantitative limitations of the public sector that is struggling with an overload in urban areas, but also by the attractiveness of private health insurance packages offered by many private health care providers. The main international health care providers in Romania that constitute the case studies of this paper are: Medlife, Regina Maria, Medicover, Sanador and Gral Medical.