Welfare Reform on the Web (April 2010): Healthcare - overseas
Cost awareness when prescribing treatment
R. Magnezi and others
British Journal of Healthcare Management, vol. 16, 2010, p. 62-71
Healthcare systems increasingly need doctors to cut costs and recognise financial constraints. This research explored the attitudes of primary care physicians in one health maintenance organisation in Israel to considering costs when prescribing tests and treatment for patients. Survey responses showed that physicians' awareness of the costs of common medical treatments was low. Physicians in management positions, and those who had attended seminars on the subject, demonstrated more cost awareness. Physicians with greater seniority and specialists were more cost-conscious that newer physicians and non-specialists. It is concluded that physicians need regular education and training by their employers to be cost conscious, and that they should be more involved in the financial aspects of healthcare.
Empowerment and Indigenous Australian health: a synthesis of findings from Family Wellbeing formative research
K. Tsey and others
Health and Social Care in the Community, vol. 18, 2010, p. 169-179
This paper employs thematic qualitative analysis to synthesise seven discrete formative evaluation reports of an Indigenous Australian family empowerment programme across four settings in Queensland and the Northern Territory between 1998 and 2005. The study aimed to develop a deeper understanding of the nature and benefits of empowerment programmes in the context of indigenous Australia. The participants' narratives showed a heightened sense of Indigenous and spiritual identity, respect for self and others, enhanced parenting, and capacity to deal with substance abuse and violence. The study confirms that psychosocial empowerment programmes are important resources for helping people engage with and benefit from health and other behaviour modification interventions and take advantage of any reforms made within macro policy environments.
Gender equity in health: the shifting frontiers of evidence and action
G. Sen and P. Ostlin (editors)
London: Routledge, 2010
This volume brings together experts from a variety of disciplines, such as medicine, biology, sociology, epidemiology, anthropology, economics and political science, who focus on three areas: health disparities and inequity due to gender, the specific problems women face in meeting the highest attainable standards of health, and the policies and actions that can address them. Highlighting the importance of intersecting social hierarchies (e.g. gender, class and ethnicity) for understanding health inequities and their implications for health policy, contributors detail and recommend policy approaches and agendas that incorporate, but go beyond commonly acknowledged issues relating to women's health and gender equity in health.
Growing inequalities and reproductive health in transitional countries: Kazakhstan and Belarus
N. Danilovich
Journal of Public Health Policy, vol. 31, 2010, p. 30-50
This study examines how growing socio-economic inequalities in transition states affect women's access to reproductive healthcare. Kazakhstan has marketised its healthcare system since the break up of the USSR, while Belarus has maintained the old Soviet system virtually intact. The paper presents empirical evidence of a relationship between socio-economic status and access to and satisfaction with reproductive healthcare, self-reported reproductive health status and reproductive history in these two transition states. The major finding demonstrates substantial disparities in access to reproductive health care among the Kazakhstani women by income and education compared to the Belarusian women.
Healthcare systems in Europe: towards an incorporation of patient access
N. Reibling
Journal of European Social Policy, vol. 20, 2010, p. 5-18
The core of existing healthcare typologies is the public-private mix in the three areas of funding, provision and regulation of services. This article aims to contribute to the debate by adding 'healthcare access' as a key variable for comparing healthcare systems. Based on empirical indicators for three different dimensions of healthcare access - gatekeeping, cost sharing and supply - a cluster analysis is performed that yields four access regime types: financial incentive states; strong gatekeeping/low supply states; weakly regulated/high supply states; and mixed regulation states.
Is there a Southern European healthcare model?
F. Toth
West European Politics, vol. 33, 2010, p. 325-343
This article explores whether the healthcare systems of Greece, Italy, Portugal and Spain present common traits that distinguish them both from those countries which have a social insurance system and those countries which provide a free universal service funded out of taxation. The analysis shows that the health systems of Greece, Spain, Italy and Portugal have features in common: 1) all had a similar genesis as far as timing and the method of transition from a universal model are concerned; 2) all except Italy show traces of earlier social insurance systems; 3) all are extensively reliant on private provision; and 4) citizens show low levels of satisfaction with the system in all four countries. It is concluded that these common traits make the health services of Southern Europe substantially different from those of Northern European countries.
Municipal governments' role in averting access problems associated with market reform
Y. Bartholomee and H. Maarse
Journal of Health Services Research and Policy, vol. 15, 2010, p. 36-40
In 2006 new legislation came into force in the Netherlands which obliges all residents to purchase a basic health insurance plan of their choice covering a wide range of medical services, including GP care, drugs, hospital care and maternity care. Being uninsured is forbidden. The legislation aims to encourage individual responsibility and to enhance consumer choice. In the view of municipal governments, social assistance recipients in their areas are not competent to make informed choices about health plans and need support. This study explores how municipal governments supplied administrative support to prevent vulnerable people in their communities becoming uninsured.
Obama could pay a high price for historic victory on health reform
T. Harnden
Daily Telegraph, Mar. 23rd 2010, p. 15
President Obama's historic healthcare reform bill, which will expand health insurance cover to 32 million Americans currently without it, is due to be signed into law on March 23rd 2010. Key points are:
- From 2014, most Americans who do not have health insurance will face a federal fine.
- More lower income people aged under 65 will be covered by Medicaid. Under the new rules, households earning up to 133% of the federal poverty level would be eligible.
- From 2013, almost everyone else will be forced to buy health insurance through a new state-run insurance exchange. Lower and middle income households will be subsidised.
- Insurance companies will no longer be able to bar children with pre-existing illnesses. Children will also be allowed to stay on their parents' insurance policy until they reach the age of 26.
- Subsidies to enable small businesses to provide health cover for employees will be introduced in 2013. Bigger businesses that do not offer affordable cover to staff will be fined up to £2,000 per employee in receipt of tax credits to buy insurance.
- Drug companies will face an annual fee of at least £1.7bn to pay the bill for the new scheme. The insurance industry will have to pay an annual fee of £5.3bn, rising in subsequent years.
A proposal that speaks to the heart of America
D. Noble
Health Service Journal, Mar. 11th 2010, p. 14-15
President Obama's healthcare reform bill has been watered down, and proposals for a centralised, government-run insurance scheme now seem unlikely to be passed. However, the bill still includes proposals for tackling insurance companies that refuse to provide cover for previous medical problems; the insurance exchange in a modified form; an expanded programme for the poorest; and saving $1 trillion through disease prevention. It is hoped that employers will take more responsibility for providing insurance with access to the incentivised exchange. The watered down version of the bill should offer 60% of uninsured Americans better access to healthcare.
A reader in promoting public health: challenge and controversy. 2nd ed.
J. Douglas and others (editors)
London: Sage, 2010
The book brings together a selection of readings that reflect and challenge current thinking in the field of multidisciplinary public health. The chapters address issues that are high on the agenda in the public health area, such as:
- the links between research and current practice, showing how research influences public health policy initiatives;
- the global context of promoting public health through policy;
- public health and health promotion in a participatory and community context.
Reproductive health and the millennium development goals: sustaining and planning for target attainment
V.K. Pillai and L. Johnson
International Journal of Sustainable Society, vol.2, 2010, p. 17-25
Three of the eight Millennium Development Goals to be achieved by 2015 relate to reproductive health. Progress towards achieving the Millennium Development Goals has been slow and uneven. This article explores the impact of reproductive rights and monetary assistance on attaining the Goals related to reproductive health. The analysis suggests that countries with a high level of reproductive health enjoyed high levels of reproductive rights. It is concluded that a rights-based approach to reproductive health may be an effective method of achieving the Millennium Development Goals.
Toward disorganised governance in public service provision? The case of German sickness funds
I. Bode
International Journal of Public Administration, vol. 33, 2010, p. 61-72
Over recent years, the concept of network governance has pervaded the research literature on public administration. It suggests a growing role for network-based governance and the simultaneous downgrading of command-and-control bureaucracy and New Public Management. The author challenges this reading of the situation, using a case study of the German sickness funds. Multi-stakeholder collaboration and inter-organisational partnerships (i.e. network governance) have existed for decades in this field, but are now being disrupted by the intrusion of market mechanisms.