Ownership
Who legally owns hospitals, beds, clinics, pharmacies, laboratories, schools, research institutes, and production assets?
38 countries · domestic sources · original languages
Who actually runs healthcare?
“Public” and “private” are not two kinds of health system. A country can have privately owned clinics, compulsory public payment, national prices, publicly controlled training, and government-planned hospital capacity—all at once.
Four separate questions
There is no honest one-number “public healthcare” score.
Payment
How much is paid through government schemes, compulsory contributory systems, voluntary insurance, and households?
Public control
Who controls prices, benefits, training supply, capital, equipment, provider entry, procurement, and service obligations?
Vertical integration
Which adjacent stages—from education and research to facilities, purchasing, and pricing—are connected through public institutions?
The research database
Measured, missing, and still under review.
This is a versioned database, not a finished scorecard. Every accepted number points to its source. Missing data are tracked as work items. New findings remain outside the published observation set until their definitions and calculations survive review.
Country × research-domain coverage
Loading coverage across 38 countries and 24 research domains…
Missing is not zero. It identifies a variable or institutional relationship that still needs comparable primary evidence. Pending candidates are not counted as accepted observations.
Published release: loading…
The system atlas
Every current OECD member. No silent omissions.
The table publishes accepted findings with their evidence status. “Reviewing” means domestic sources are being checked; “Unknown” means the evidence does not yet support a comparable claim. Neither means zero.
Verified Direct evidence supports the claim.
Partial Some dimensions or denominators remain unresolved.
Conflicted Sources or classifications cannot safely be merged.
Unknown No defensible figure was found; never treated as zero.
38 countries
| Country | Source language | Ownership | Payment | Public control | Vertical integration | Evidence |
|---|---|---|---|---|---|---|
| Loading the 38-country evidence map… | ||||||
Country universe · CSV
Country registry · CSV
Observations · CSV
Series registry · CSV
Observation provenance · CSV
Claims · CSV
Source ledger · CSV
Local terminology · CSV
Coverage matrix · CSV
Data-gap queue · CSV
Provenance QA · CSV
U.S. capability tests · CSV
Release history · CSV
Database metadata · JSON
Evidence bundle · JSON
Methodology
What the reconstruction changes
The public sector is often more powerful than the ownership column suggests.
Beds tell a different story than buildings.
Germany’s public category held 28.7% of hospitals but 46.8% of beds in 2024. France’s public share was 44.9% of establishments but 70.3% of beds within the narrower MCO acute-care scope. In Japan, the combined national and official-public categories were 18.60% of hospitals and 28.85% of beds.
Public payment does not answer who holds title.
Austria reported 75.7% of current health spending as public in 2024 while a clean current hospital-owner numerator remained unavailable. The Netherlands reported 82.54% through government and compulsory schemes in 2023, yet its national hospital-owner split also remained unknown. Financing power and asset ownership are different facts.
Public production chains are real—and usually bounded.
Portugal’s public ULS entities integrate hospital and primary-care operation. Germany, Spain and Switzerland retain bounded military medicine-production capacity. Public universities frequently connect education, training, research and clinical care. None of those facts makes an entire national pharmaceutical or delivery system publicly owned.
Portugal · Diário da RepúblicaGermany · BundeswehrSpain · Defence Ministry
Country dossier
Follow one system through the whole chain.
Select a country to inspect its verified ownership, payment, control, vertical-integration evidence, fourteen production layers, and explicit uncertainties.
The production chain
Fourteen layers, mapped separately.
- 01Medical education
- 02Postgraduate training
- 03Healthcare workforce
- 04Hospitals
- 05Ambulatory & primary care
- 06Pharmacies
- 07Pharmaceutical research
- 08Pharmaceutical manufacturing
- 09Devices & capital goods
- 10Healthcare research
- 11Insurance & financing
- 12Price setting
- 13Billing & transparency
- 14Capital investment
The hidden public sector
Private legal form can sit inside a public operating system.
A physician may own a practice but receive nearly all payment through a statutory pool, bill a national fee schedule, train in publicly allocated slots, and operate where government planning permits capacity. Calling that provider simply “private” hides most of the institutional architecture.
This project therefore records legal ownership, operator status, employment, financing, purchasing, price authority, capacity control, profit and loss exposure, and service obligations separately.
Evidence standard
Research the country in the country.
Original language first
Search domestic government, legal, statistical, regulatory, public-university, and statutory-institution sources in the language in which the system operates.
Preserve the institution
Every major claim retains the original title and passage, English translation, local term, literal meaning, functional meaning, date, year, and URL.
Aggregators discover
OECD data support comparable baselines. Search engines, Perplexity, and English summaries locate leads. Domestic sources establish structural claims.
Unknown beats wrong
We do not average unrelated denominators, convert financing into ownership, infer control from regulation alone, or score missing cells as zero.
Sources and reproducibility
The receipts are part of the product.
The downloadable ledgers expose every published observation and structural claim, including conflicting classifications and evidence gaps. Country dossiers link to the original domestic document—not merely to a comparative summary.
OECD confirms that the organization currently has 38 member countries. The membership list defines this study's country universe. OECD members and partners