THE PUBLIC-PRIVATE PARTNERSHIP - A BENEFIT OR A CHALLENGE FOR THE MACEDONIAN PUBLIC HEALTHCARE SYSTEM

Abstract

Financing the public health system remains a major challenge for post-transition countries and small economies such as the Republic of North Macedonia. Healthcare PPPs require the setup of complex legal and financial frameworks. They are usually set up to mitigate the fiscal costs and public finance resources needed to build capital infrastructure. Lately, the public enterprises established by the government or the local government in the region have entered long-term purchase agreements that are like PPPs. In practice, PPPs are very popular in the transport, energy, and water sectors (investment in infrastructure in toll roads, electricity networking, water supply and wastewater treatment, etc.). However, when it comes to the PPPs in the public healthcare sector, these models of financing seem to be facing restrictions and don`t enjoy the same popularity as in other sectors for public services. Therefore, this paper will overview the appearance and legal position of the PPPs in the Macedonian public healthcare system and new competences for sustainable public healthcare systems. In addition, it will tackle the question: What are the legal positions of the public and private partners, and what are the financial implications (pros and cons) of using this model of investment in the public healthcare system?