In any health system there are stakeholders than have ‘vested or special interests’. That is, that pursue a private gain (e.g. profit) as its main goal. When special interests run the health system, it runs the risk of departing from attaining its collective mission of improving the health and welfare of its population. This has led to a strand of the literature that examines the mechanisms that such interest groups use to attain their goals. This includes the design of the underpinning institutions in place in each health system.