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Welfare Reform on the Web (July 2002): Health Care - Overseas

ALTERNATIVE PRESCRIPTIONS: A SURVEY OF INTERNATIONAL HEALTHCARE SYSTEMS

S. Williams

London: Conservative Party, 2002

Reviews health care systems in 20 major Western nations in order to learn from the way that other countries organize their health services.

BATTLE FATIGUE

H. Berliner

Health Service Journal, vol. 112, Apr. 25th 2002, p. 26

As the US economy moves into recession, the cost of the Medicaid programme, which provides healthcare for poor Americans, is rising. The States have appealed for an increase in federal funding. This is not forthcoming as Congress has spent the federal budget surplus on tax cuts.

A BRITISH WARNING FOR AMERICAN HEALTHCARE

A. Shlaes

Financial Times, Apr. 24th 2002, p. 17

State funding of US healthcare is increasing with the expansion of the Medicare and Medicaid programmes. This expansion is fuelled by public demands for more entitlements coupled with new regulations which discourage health entrepreneurs.

DILEMMAS OF EMOTION WORK IN NURSING UNDER MARKET-DRIVEN HEALTH CARE

D. Bone

International Journal of Public Sector Management, vol. 15, 2002, p. 140-150

Emerging profit-driven health maintenance organisations in the US have emphasized cost containment in service delivery. This approach has placed time constraints on nurses that prevent them from offering emotional support to patients. Paradoxically managed care has also increased the demand for emotional competency in nurses through its emphasis on achieving patient satisfaction.

ELICITING PREFERENCES FOR RESOURCE ALLOCATION IN HEALTH CARE

E. O'Shea

Economic and Social Review, vol. 32, 2001, p. 217-238

Rising public expenditure on healthcare worldwide has led policy-makers to focus on rationing or priority-setting to ensure "value for money". Paper provides information on rankings and willingness-to-pay estimates for marginal changes to three healthcare programmes in Ireland:

  • cancer;
  • cardiovascular;
  • community care.

People ranked cancer as their preferred programme, but were unable to distinguish between the three programmes in terms of monetary valuation. There was no significant difference in willingness-to-pay among the three programmes.

FORMAL POOLING OF HEALTH RISKS IN SUB-SAHARAN AFRICA: REFLECTIONS ON THE OBSTACLES ENCOUNTERED

B. Meessen, B. Criel and G. Kegels

International Social Security Review, vol. 55, no. 2, 2002, p. 71-93

Discusses reasons for the lack of enthusiasm for mutual benefit societies in Africa. These include lack of information, lack of competent fund managers, difficulty of punishing fraud, excessive physical transaction costs, and expected benefits that are too low, too uncertain or too distant in time.

HEALTH CARE AS CITIZENSHIP DEVELOPMENT: EXAMINING SOCIAL RIGHTS AND ENTITLEMENT

C. J. Redden

Canadian Journal of Political Science, vol. 35, 2002, p. 103-125

Article begins by examining the validity of rights, and the soundness of philosophical justifications for various conceptions of right, holding that rights are important politically, in spite of their philosophical weaknesses. Building on these observations, article goes on to determine the precise meaning of the right to healthcare by considering three possible conceptions of right. It proceeds to argue that the right to healthcare has its roots in non-possessive non-property-based rights, a conception that is in tension with current individualistic rights claiming.

HEALTH SECTOR REFORM AND PUBLIC SECTOR HEALTH WORKER MOTIVATION: A CONCEPTUAL FRAMEWORK

L. M Franco, S. Bennett and R. Kanfer

Social Science and Medicine, vol. 54, 2002, p. 1255-1266

Health sector performance is critically dependent on worker motivation, as health care delivery is highly labour-intensive. While resource availability and worker competencies are essential, they are not sufficient in themselves to ensure performance. Policy makers can facilitate improved motivation and goal congruence by:

  • addressing multiple channels for worker motivation;
  • recognizing the importance of communication and leadership for reforms;
  • identifying organizational and cultural values that might facilitate or impede implementation of reform;
  • understanding that reforms may impact differently on various cadres of health workers.

HEALTH TARGETS IN EUROPE: POLITY, PROGRESS AND PROMISE

M. Marinker

London: BMJ Books, 2002

Looks at the revolutionary approach to health policy following the World Health Organisation's initiative, "Health for All by the Year 2000." This book gives historical perspectives on European health policy, looks at arguments for and against health targets, and explores the values underpinning targets for health improvement in seven European countries. It addresses the relevance of health targets in the European political environment and explores the roles of stakeholders at all levels.

MANAGED CARE AND THE US HEALTH CARE SYSTEM: A SOCIAL EXCHANGE PERSPECTIVE

D. E. Grembowski and others

Social Science and Medicine, vol. 54, 2002, p. 1167-1180

In the US healthcare system purchasers have historically had a power advantage over managed care organisations (MCOs), MCOs over physicians, and physicians over patients. An analysis of the system from the point of view of social exchange theory reveals that relationships on all levels have moved towards a power balance in the last decade.

POLICY EMERGENCE AND POLICY CONVERGENCE: THE CASE OF "SCIENTIFIC - BUREAUCRATIC MEDICINE" IN THE UNITED STATES AND UNITED KINGDOM

S. Harrison, M. Moran and B. Wood

British Journal of Politics and International Relations, vol. 4, 2002, p. 1-24

By examining the similar approaches to the management of medical care which emerged in public policy agendas in the United Kingdom and United States in the 1990s, this article looks at how explanations of policy emergence in single countries can be reconciled with policy convergence between two countries.

SHARED TREATMENT DECISION MAKING IN A COLLECTIVELY FUNDED HEALTH CARE SYSTEM: POSSIBLE CONFLICTS AND SOME POTENTIAL SOLUTIONS

M. Sculpher, A. Gafni and I. Watt

Social Science and Medicine, vol. 52, 2002, p. 1369-1377

In recent years there has been a growing advocacy of clinicians sharing treatment decisions with patients. Key characteristics of shared decision making (SDM) include provision of comprehensive and comprehensible information to patients regarding treatment options and willingness of clinicians to share deliberation and decisions regarding appropriate management. However a move towards great SDM in collectively funded systems may accentuate conflicts between the demands of individual patients and the interests of other patient groups.

SOCIAL HEALTH INSURANCE IN DEVELOPING COUNTRIES: A CONTINUING CHALLENGE

G. Carrin

International Social Security Review, vol. 55, no. 2, 2002, p. 57-69

Article addresses the issue of the feasibility of social health insurance in developing countries, with its intention basically to involve all population groups.

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