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Welfare Reform on the Web (April 2003): Health Care - Overseas

CO-ORDINATING HEALTH TECHNOLOGY ASSESSEMENT IN CANADA: A EUROPEAN PERSPECTIVE

D McDaid

Health Policy, vol. 63, 2003, p.205-213

Health Technology Assessment (HTA) is well established in Canada with both a national co-ordinating office and several provincial organisations. Interviews were conducted with a number of key individuals associated with HTA in Canada to identify achievements, examine the relationship between provincial agencies and the national co-ordinating office, and detect barriers to the increased use of HTA knowledge in decision-making.

EVALUATING HEALTH INTERVENTIONS: EXPLOITING THE POTENTIAL

A Maynard and D McDaid

Health Policy, vol. 63, 2003, p.215-226

The importance of the evaluation of health interventions, including health technology assessment (HTA), cannot be over-emphasized as its results can improve resource allocation decisions in all parts of the health care system, public and private. The potential of HTA is great, but remains unexploited in many developed countries.

EVALUATION OF HEALTH INTERVENTIONS IN SOCIAL INSURANCE-BASED COUNTRIES: GERMANY, THE NETHERLANDS AND AUSTRIA

C Wild and B Gibis

Health Policy, vol. 63, 2003, p.187-196

Article focuses on the opportunities for, and obstacles to, health technology assessment (HTA) in Germany, Austria and the Netherlands, as countries with insurance based healthcare systems. A tradition of professional autonomy and sectoral interests hindered the implementation of HTA in Austria and Germany. On the other hand, HTA has long been practised in the Netherlands. In all three countries sickness funds play an important role in implementing HTA as a means of controlling reimbursement costs.

FINANCING HEALTH SERVICES FOR PENSIONERS IN ARGENTINA: A SALUTARY TALE

P Lloyd-Sherlock

International Journal of Social Welfare, vol. 12, 2003, p.24-30

PAMI is a dedicated state-supported health fund for Argentinian pensioners. The programme is accumulating large deficits and many of its services are of doubtful quality. Article finds that commercial insurance has a bias against covering all but the richest older people. As a result, most older people have remained in the hands of this increasingly beleaguered semi-public fund.

FORECASTING THE DEMAND FOR HEALTH CARE IN OECD NATIONS AND CHINA

R W Fogel

Contemporary Economic Policy, vol. 21, 2003, p.1-10

Over the past century, technological advances and improvements in physical well-being have enabled the average length of retirement to increase fivefold, the proportion of a cohort that lives to retire to increase sevenfold, and the amount of leisure time available to those still in work to increase nearly fourfold. However these boons are associated with sharply rising expenditure on health care as chronic diseases attack the ageing population. Article goes on to discuss whether medical advances will spare OECD nations' health systems from a financial crisis.

FROM HEALTH TECHNOLOGY ASSESSMENT TO RESEARCH ON THE ORGANISATION AND DELIVERY OF HEALTH SERVICES: ADDRESSING THE BALANCE

N Fulop and others

Health Policy, vol. 63, 2003, p.155-165

Health Technology Assessment (HTA) research needs to be complemented by a research focus on the organisation and delivery of health services. The latter has recently started to receive more funding and attention. Presents case studies of how two such initiatives in England and Canada have set priorities for this type of research. An example of an issue in the delivery and organisation of healthcare (how to deliver orthopaedic care) is used to illustrate how a number of different disciplines can be applied.

HEALTH ECONOMIC EVALUATION IN JAPAN: A CASE STUDY OF HEALTH TECHNOLOGY ASSESSMENT

A Oliver

Health Policy, vol. 63, 2003, p.197-204

Although Japan is the world's second largest health care market, it has shown little interest in health economic evaluation. The fee-for-service and strict price regulation that characterises Japanese healthcare financing is not conducive to this form of analysis. Moreover the government and many researchers are satisfied with the present system, which has delivered long life and low infant mortality at low cost.

HEALTHCARE FINANCING REFORM AND THE NEW SINGLE PAYER SYSTEM IN THE REPUBLIC OF KOREA: SOCIAL SOLIDARITY OR EFFICIENCY?

S Kwon

International Social Security Review, vol. 56, no. 1, 2003, p.75-94

In July 2000, national health insurance in Korea was changed to a single insurer system through the merger of over 350 health insurance societies. Inequity in healthcare financing across income and occupation groups was a major concern leading to the reform. Differences in financial capacity among insurance societies and the chronic financial instability of the rural ones also contributed to the changes.

INTERNATIONAL NGOS AND PRIMARY HEALTH CARE IN MOZAMBIQUE: THE NEED FOR A NEW MODEL OF COLLABORATION

J Pfeiffer

Social Science and Medicine, vol. 56, 2003, p.725-738

International aid has been increasingly channelled through non-governmental organisations (NGOs) and their expatriate technical experts to support primary health care in the developing world. The Mozambique experience reveals that the flood of NGOs and their expatriate workers over the last decade has fragmented the local health system, undermined local control of health programmes and contributed to growing local social inequality. Since the salaries of national health workers plummeted over the same period as a result of structural adjustment, they became vulnerable to financial favours offered by NGOs seeking to promote their projects in turf wars with other agencies.

LATIN LESSONS GIVE A GRASSROOTS INSIGHT

G Meads and M Iwami

Primary Care Report, vol. 5, Feb. 5th 2003, p.17-10

Discusses progress across Latin America with decentralisation of, and promotion of local community involvement in, development and management of primary care services.

MANAGED CARE AND TRADITIONAL INSURANCE: COMPARING THE QUALITY OF CARE

D Simonet

International Social Security Review, vol. 56, no. 1, 2003, p.95-113

Article reviews research comparing quality of care under the traditional "fee-for-service" system with that given by "managed care" providers in the USA. Outcomes have been mixed, with most studies reporting a decline in the propensity of patients of health maintenance organizations to seek treatment, and lower patient satisfaction. The quality of care has not deteriorated except in the case of vulnerable groups.

RESTRUCTURING HEALTH SERVICES: CHANGING CONTEXTS AND COMPARATIVE PERSPECTIVES

K Sen (ed)

London: Zed Books, 2003.

Examining the rapidly changing context of health care and its relationship to globalisation and privatisation, this book looks at the specific mechanisms and institutional processes involved. It explores the conceptual and legislative framework; the process of change; and provides case studies of restructuring from a comparative perspective.

THE ROLE OF THE MEDIA IN STEERING PUBLIC OPINION ON HEALTH CARE ISSUES

E Benelli

Health Policy, vol. 63, 2003, p.179-186

In 1997 one Luigi di Bella claimed to have developed a cure for cancer. The media supported Di Bella's claims about his unproven treatment and eventually forced the Italian government to fund large scale trials of the intervention, which proved to be worthless.

URBANIZATION AND HEALTH CARE IN RURAL CHINA

G G Liu and others

Contemporary Economic Policy, vol. 21, 2003, p.11-24

Date from the China Health and Nutrition Survey show that urbanisation leads to a significant and equitable increase in health insurance coverage. Analysis also shows that people with insurance are far more likely to obtain care than those without. In addition, income and individual health status are also highly predictive of insurance coverage.

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