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Welfare Reform on the Web (October 2001): Health Care - Overseas

AT RISK IN AMERICA: THE HEALTH AND HEALTH CARE NEEDS OF VULNERABLE POPULATIONS IN THE UNITED STATES

L.A. Aday

San Francisco: Jossey-Bass Publishers, 2001.

Discusses the impact of the rising number of uninsured people in America and the emphasis being put on cost-effective practices in medicine. It concentrates on those key population groups most vulnerable to disease and injury in the United States today. The book reviews major theories and knowledge concerning at risk groups and offers new approaches and methodologies for tracing social determinants of health. It also looks at emergency trends in the health care system.

BRITISH GPs SUFFER BY COMPARISON

D. Charter

Times, Aug. 8th 2001, p.12

Article gives a brief comparison of key indicators of the German and United Kingdom health care systems. Germany has 3.4 physicians per 1,000 people against 1.7 per 1,000 in the UK. The article discusses figures compiled by the Organisation for Economic Co-operation and Development (OECD) on indicators such as public spending, length of time spent in hospital, life expectancy figures and figures on the number of appointments per GP a year.

EQUITY IN HEALTH IN UNEQUAL SOCIETIES: MEETING HEALTH NEEDS IN CONTEXTS OF SOCIAL CHANGE

G. Bloom

Health Policy, Vol.57, 2001, p.205-224

Paper argues that unregulated markets for healthcare are neither equitable nor efficient. Governments must play a role in supporting the organisation of health services used by different social groups. Countries with low levels of income inequality may be able to provide universal access to relatively sophisticated health services. Otherwise governments need to operate within a segmented system. This means persuading social elites that it is in their interests to support the provision of health care for the poor. This can be done by representing the poor as potential sources of infection or dangerous rebellion.

GERMAN LESSONS

D. Walker

Guardian, Aug. 16th 2001, p.17

The NHS is not unique in being affected by inefficiency and poor standards of care. The German health service is also in crisis, but unlike in the UK, part of the problem arises from over-provision, leading to many people paying for useless treatments.

HEALTH AND HEALTHCARE IN THE EU: A FINANCIAL PERSPECTIVE

T. Jones

London: Association of Chartered Certified Accountants, 2001.

Argues that present levels of real terms annual growth in NHS spending would have to be sustained for seven years to bring the UK close to the EU average. However this would still be below the modal point that reflects the spending of the more modern EU economies. Suggests, however, that improvements in quality can nevertheless be achieved over the coming three years by building on the NHS's "excellent record of cost control".

PATIENTS PLAY ROULETTE WITH AILING SERVICE

R. Boyes

Times, Aug. 8th 2001, p.12

Article discusses the German healthcare system, its strengths and its gradual breakdown. State insurance funds are based on the contributions of tens of millions of Germans but can no longer cope with an ageing population and the spiralling cost of new medicines and new diagnostic machinery.

PUBLIC AND PRIVATE ROLES IN HEALTH CARE SYSTEMS: REFORM EXPERIENCE IN SEVEN OECD COUNTRIES

C. Scott

Buckingham: Open University Press, 2001.

This book looks at seven OECD (Organisation for Economic Cooperation and Development) countries have been reviewing and modifying their health care systems over recent years. It examines both the theory and practice surrounding public and private sector roles in the health care systems. It discusses the defining of appropriate roles, relationships and interfaces among public and private organisations in the funding, purchasing and provision of health care. It concentrates on the experiences of Australia, Canada, Germany the Netherlands, New Zealand, US and UK.

PHYSICIAN DISTRIBUTION AND PHYSICIAN SHORTAGE INTENSITY IN ONTARIO

B. Kralj

Canadian Public Policy, Vol.27, 2001, p.166-178

Paper applies the Gini index of resource concentration methodology to gauge the maldistribution of physician resources in Ontario in the 1990s. It also proposes, and implements, an approach for quantifying physician shortages through a physician shortage intensity index. Results reveal that, despite numerous government policies and programmes aimed at alleviating the geographic maldistribution of medical human resources, the distribution of physicians in Ontario has become more uneven during the 1990s. This puts the efficacy of government policies to correct geographic maldistribution into question. Additionally, there has been no meaningful improvement in overall physician shortage intensity during the 1990s.

QUALITY IN HEALTH CARE: STRATEGIC ISSUES IN HEALTH CARE MANAGEMENT

H.T.O. Davis, M. Tavakoli and M. Malek (eds)

Aldershot: Ashgate, 2001

This book examines the issue of quality in health care by drawing on experts from Europe and America. It looks at system issues and at case studies on bringing about quality improvement. It examines variations in health care and incorporates the users views.

SCHOOL DAZE

H. Berliner

Health Service Journal, Vol.111, July 26th 2001, p.30-31

Most US medical schools have adopted programmes of affirmative action to encourage ethnic minority applicants, but these have not been completely successful in increasing diversity. There have also been some law suits against medical schools by rejected applicants claiming reverse discrimination. Most minority groups are experiencing a downturn in representation in medicine and the movement to humanise medicine by widening entrance criteria has faded away.