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Figure 18: Substantial variation in costs for treating the same disease
between public and private sector (outpatient care)

Figure 19: substantial variation in costs for treating the same disease
between public and private sector (Inpatient care)

5.29 Credit rating agencies mitigate the information asymmetry faced by investors when
investing in the debt of a firm. Specifically, credit rating agencies assess the likelihood of the
firm repaying the debt that is takes from the investors, thereby the quality of the firm borrowing
the money. Similarly, healthcare policymakers should consider creating agencies to assess the
quality of the healthcare providers – both doctors and hospitals. The Quality and Outcomes
Framework (QOF) introduced by the National Health Service (NHS) in the United Kingdom
2004 as well as other quality assessment practices introduced by NHS provide a good example.
The NHS quality assessment practices included national standards for the major chronic
diseases, annual appraisal of all doctors working in the NHS, and widespread use of clinical
audits to compare practices, sometimes with public release of data. These should be evaluated
carefully and considered for implementation.

5.30 Credit bureaus assess the quality of individual borrowers by assigning them credit scores,
thereby mitigating the information asymmetry faced by a bank or financial institution in lending
to the individual borrower. In the healthcare context, insurers as well as healthcare providers