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Welfare Reform on the Web (November 2000): Health Care - Overseas

APPRAISING THE FINANCIAL REFORM IN BULGARIAN PUBLIC HEALTH CARE SECTOR: THE HEALTH INSURANCE ACT OF 1998

M. Pavlova, W. Groot and F. van Merode

Health Policy, vol. 53, 2000, p. 185-199

Paper explores the social benefits and feasibility of insurance-based finance in the Bulgarian state health care system. Concludes that, given the current economic recession, insurance-based healthcare finance cannot be socially beneficial for Bulgaria. Implementation also appears to be not feasible due to a lack of financial resources.

FINANCING REFORMS FOR THE THAI HEALTH CARD SYSTEM

S. Pannarunothai and others.

Health Policy and Planning, vol. 15, 2000, p. 303-311

The health card scheme in Thailand operates as a voluntary health insurance scheme for farmers and workers in informal sectors at the community level. The paper evaluates the changes to the scheme, cost recovery of the funds and of health care providers, the administrative cost of the scheme and the operation of the reinsurance policy. After comparing it with other compulsory insurance schemes it rises the policy question of whether this voluntary scheme should become compulsory.

HEALTH CARE IN HONG KONG AND MAINLAND CHINA: ONE COUNTRY, TWO SYSTEMS?

K.A. Fitzner et al

Health Policy, vol. 53, 2000, p. 147-155

Hong Kong has adopted health care financing and organisational health systems that are commonly found in centrally planned economies, while its economy functions as a highly capitalistic enterprise. In contrast, mainland China has integrated many features of healthcare systems associated with market economics, while its overall economy is largely centrally planned. Paper examines the policy factors associated with these disparate health systems and investigates whether they can be maintained according to the "one country, two systems" approach adopted by Chinese policy makers.

THE PARADOX OF THE COST AND AFFORDABILITY OF TRADITIONAL AND GOVERNMENT HEALTH SERVICES IN TANZANIA

S.H. Muela, A.K. Mushi and J.M. Ribera

Health Policy and Planning, vol. 15, 2000, p. 296-302

Since the introduction of user fee systems in the government health facilities of most African countries, which shifted part of the burden of financing health care onto the community, affordability of basic health care has been a much discussed topic. In the article the authors suggest that the ability to pay for traditional treatment can differ from ability to pay for hospital attendance for two main reasons. First, many healers offer alternatives to cash payments, such as compensation in kind or in work, or payment on a credit basis. Secondly, the activation of social networks for financial help is different for the two sectors. Payment for traditional treatment may involve contributions from an extended kin-group while hospital treatment costs are usually covered by the patient himself, or a small circle of relatives.

PUBLIC PURCHASING AND PRIVATE PRIORITIES FOR HEALTHCARE IN NEW ZEALAND

P. Howden-Chapman and T. Ashton

Health Policy, vol. 54, 2000, p. 27-43

Paper analyses several aspects of the New Zealand health reforms of the 1990s, including prioritisation of patients and services, equity of access, and the impact of competitive contracting. In particular, aspects of resource allocation and the balance between private and public providers are explored. Key factors influencing the performance and public perception of the health care system are identified and conclusions drawn about future policy processes.

A QUESTION OF TRUST

H. Berliner

Health Service Journal, vol. 110, Sept. 14th 2000, p. 32

US doctors are advocating collective bargaining and unionisation in their latest battle with health maintenance organisations.

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