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Welfare Reform on the Web (June 2008): Healthcare - overseas

Differential diagnoses: a comparative history of health care problems and solutions in the United States and France

P. V. Dutton

London: Cornell University Press, 2007

Although the United States spends 16 percent of its gross domestic product on health care, more than 46 million people have no insurance coverage, while one in four Americans report difficulty paying for medical care. Indeed, the U.S. health care system, despite being the most expensive health care system in the world, ranked thirty-seventh in a comprehensive World Health Organization report. With health care spending only expected to increase, Americans are again debating new ideas for expanding coverage and cutting costs. According to this book, Americans should look to France, whose health care system captured the World Health Organization's number-one spot. The book debunks a common misconception among Americans that European health care systems are essentially similar to each other and vastly different from U.S. health care. In fact, the Americans and the French both distrust 'socialized medicine.' Both peoples cherish patient choice, independent physicians, medical practice freedoms, and private insurers in a qualitatively different way to the Canadians, the British, and many others. The United States and France have struggled with the same ideals of liberty and equality, but one country followed a path that led to universal health insurance; the other embraced private insurers and has only guaranteed coverage for the elderly and the very poor. How has France reconciled the competing ideals of individual liberty and social equality to assure universal coverage while protecting patient and practitioner freedoms? What can Americans learn from the French experience, and what can the French learn from the U.S. example? The book answers these questions by comparing how employers, labour unions, insurers, political groups, the state, and medical professionals have shaped their nations' health care systems from the early years of the twentieth century to the present day.

Implementing management tools in Turkish public hospitals: the impact of culture, politics and role status

A.O. Ozturk and J.E. Swiss

Public Administration and Development, vol. 28, 2008, p. 138-148

The government of Turkey has attempted to substantially improve and modernise the management of its public hospitals. However, analysis shows that only minor improvements have been made. This study sought to find the underlying reasons for these disappointing results through interviews with 46 hospital managers and employees. The interviews suggested that traditional Turkish organisational culture resisted attempts to decrease hierarchy. Moreover, the system of allowing doctors in public hospitals to maintain private practices gave them the resources and the incentives to fight reform efforts. Finally, organisational decentralisation in Turkey evoked fierce political opposition, including from pro-modernising forces that feared it could increase the power of Islamic fundamentalists.

Lessons from America

C. Ham and R. Gleave

Health Service Journal, May 1st 2008, p. 16-17

The US healthcare industry can provide the NHS with valuable lessons about integration and partnership working. US integrated systems and network models of healthcare delivery:

  • Focus on provision in primary care and community settings with 'in-reach' or 'forward integration' into hospital
  • Are medically led but based on a partnership between doctors and management. Medical leaders in the successful integrated organisations work in partnership with managers on approaches to clinical and service quality and use of resources that generate a strong focus on organisation-wide performance improvement.
  • Have health IT at their heart. All the successful US integration projects have invested in IT.
  • Focus on chronic disease management and improvement of population health.

Power, politics and pharmaceuticals: drug regulation in Ireland in the global context

O. O'Donovan and K. Glavanis-Grantham

Cork: Cork University Press, 2008

The central questions that are explored in this collection of essays include: what are the implications for health of existing systems of pharmaceutical drug regulation, and what do existing systems of drug regulation reveal about the power of transnational pharmaceutical corporations to shape regulatory and other policies? The importance attached to considering the Irish regulatory system in its international context is reflected in the inclusion of chapters that address the implications of World Trade Organisation and EU regulatory policies and regulatory trends in Canada, Britain and Australia. By demonstrating how the analysis of pharmaceutical drug regulation can provide rich insights into the operation of power in contemporary society, this book challenges the prevailing construction of drug regulation as a sphere of 'policy without politics' and aims to contribute to the conception of better ways of regulating medicines.

Public-private partnerships in the health sector: the Danish experience

K. Vrangbaek

Health Economics, Policy and Law, vol. 3, 2008, p. 141-163

This article demonstrates that public-private partnerships (PPP) have been used very sparsely in the Danish health sector if a narrow infrastructural definition is used. There are few examples of large-scale partnership projects with joint investment and risk taking, but a number of smaller schemes such as jointly owned companies at the regional level. When PPPs are defined more broadly, the author identifies a long tradition of various types of collaboration between public and private actors in health care in Denmark. An analysis of the regulatory environment is then offered as an explanation for the limited use of PPPs in Denmark. Major political and institutional actors at the central level differ in their enthusiasm for the PPP concept, and the regulatory framework is somewhat uncertain.

Understanding the sociology of health: an introduction. 2nd ed.

A-M, Barry and C. Yuill

London: Sage, 2008

This new extensively revised edition draws on the latest applied sociological research and new theoretical insights into health and illness and explores subjects ranging from health inequalities to chronic illness; embodiment to research techniques; and health care organisation to social theory. The book falls into three sections. The first provides an overview of sociological perspectives on health, while the second deals with the main health inequalities of class, race and gender along with mental health, the body and ageing. The final section examines the wider influences, issues and social policies relating to the provision of institutional or community care.

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