Introduction

A broad range of health determinants are outside the scope of the health system. Public and private sectors that exist in isolation are less and less representative of reality. The implementation of national health policies in general, and the delivery of health services in particular, is increasingly complex. Privatization is a concept that at first sight appears simple. According to the dictionary definition, privatization involves the transfer of ownership of an entity from the public to the private sector, its opposite being nationalization. Intra- and extra-institutional operation is based on relationships between stakeholders in a transactional system, whether mercantile or otherwise. It would thus be wrong to think that only legal contracts have consequences. A given organization’s economic efficiency can have a considerable social cost, the consequences of which will only be felt later on and by other organizations.