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Welfare Reform on the Web (September 1999): Healthcare - Overseas

CLINTON GEARS UP FOR SPENDING BONANZA

M. Kettle

Guardian, June 30th 1999, p. 14

President Clinton has announced a new health prescription benefit worth up to $2000 a year. Cumulative budget surpluses over 15 years are expected to yield an influx of tax dollars into the US Treasury, widening the scope for spending without imposing fresh tax burdens on middle class voters.

(See also Financial Times, June 30th 1999, p. 7)

DEFENDING SOCIAL AND HEALTH SERVICES UNDER THREAT : QUESTIONS AND STRATEGIES

L. Levitt, A. H. Beckerman and P. Johnson

Journal of Social Work Practice, vol. 13, 1999, p. 59-67

Scenarios which envisage an enhanced role for social work in health care all require an increased knowledge of the workings of the market and a greater ability on the part of the profession to participate in the market as a forceful player. They require the emergence of the social work profession as an important force in efforts to reform health care in the US to achieve universal access, a uniform payment system, and more effective controls over expenditure. Health care professions need to develop a political orientation which recognises the need to organise interdisciplinary coalitions which share the struggle to protect health and social services.

A FISTFUL OF DOLLARS

H. Berliner

Health Service Journal, vol. 109, June 17th 1999, p. 28

Reports that lawsuits to reclaim the costs of treating the wounded from gun manufacturers are the latest development in US litigation.

NATIONAL HEALTH POLICIES : SUB-SAHURAN AFRICAN CASE STUDIES (1980-1990)

K. Dugbatey

Social Science and Medicine, vol. 49, 1999, p. 223-249

Four countries, Botswana, Cote d'Ivoire, Ghana and Zimbabwe were chosen as cases to study the impact of national health policies on national health status in sub-Shaharan Africa. Through a conceptual framework that covers health problem identification, policy formation and implementation procedures, the study examined national translations of Primary Health Care (PHC) and Health for All by the Year 2000 (HFA/2000) strategies. Study concluded that policies formulated and implemented in accordance with key PHC principles could account for improvements in national health status.

OBLIGATORY MEDICAL INSURANCE IN RUSSIA : THE PARTICIPANTS' PERSPECTIVE.

J. L. Twigg

Social Science and Medicine, vol. 49, 1999, p. 371-382

Paper offers a brief description of the parameters of the Russian medical insurance system introduced in 1993 to raise funds for health care. Then presents the results of a survey which asked managers of the two major new institutional participants in health care financing, private medical insurance companies and the 89 governmental Territorial Health Insurance Funds, their opinions of the structural and behavioural aspects of the new system. These survey findings illustrate the dynamics of the bureaucratic and institutional conflict which has led to incomplete and flawed implementation of the insurance system.

POLITICAL ANALYSIS OF HEALTH REFORM IN THE DOMINICAN REPUBLIC

A. Glassman and others

Health Policy and Planning, vol. 14, 1999, p. 115-126

Article presents a method of political analysis for health sector politics, and identifies key patterns in the politics of health reform proposals. Uses the experience of one country, the Dominican republic, to illustrate the political challenges of health reform.

PRIVATE HEALTH CARE IN NIGERIA : WALKING THE TIGHTROPE

I. Ogunbekun, A. Ogunbekun and N. Orobaton

Health Policy and Planning, vol. 14, 1999, p. 174-181

The inadequacy of state health care services has made the private sector an unavoidable choice for consumers of health care in Nigeria. However, ineffective state regulation has meant little control over the clinical activities of private sector providers while the price of medical services has grown faster than the average rate of inflation. Reforms aimed at increasing the efficiency of the private sector are urgently required if costs are to be contained.

QUALITY IMPROVEMENT PROJECTS IN HEALTH CARE : PROBLEM SOLVING IN THE WORKPLACE

E. Gilpatrick

Thousand Oaks, Calif: Sage, 1999.

Book reviews the basic techniques for carrying out quality improvement research. Then describes how these techniques can be implemented through 14 case studies involving actual health care situations. Written from a US perspective.

RESOURCE DEPENDENCY, DOCTORS AND THE STATE: QUALITY CONTROL IN SWEDEN

P. Garpenby

Social Science and Medicine, vol. 49, 1999, p. 405-424

Paper focuses on the interaction between the state and the medical profession on the national level in Sweden with respect to issues concerning quality development in health care. The increased politicising of the issue of health care quality resulted in public organisations having reason to increase their interaction with professional associations. Interest in the resources controlled by the profession motivated the development of inter-organisational relationships. Equally, the professional bodies also needed resources controlled by the state.

THE ROLE OF THE PRIVATIZATION PROCESS ON TUBERCULOSIS CONTROL IN HOCHIMINH CITY PROVINCE, VIETNAM

E. Naterop and J. Wolffers

Social Science and Medicine, vol. 48, 1999, p. 1589-1598

Paper describes the functioning of the National Tuberculosis Program (NTP) in the province of HoChiMinh City, and the impact of the privatisation process. Problems of double infection with HIV and TB mean that an integrated strategy for AIDS and tuberculosis is required.

This would have to include the development of a health education programme and the training of private practitioners in the treatment of TB. Health education is essential for tuberculosis control but will not be initiated within the private sector. It is essential that the NTP and the private sector co-operate in health education and training initiatives.

THE SPANISH HEALTH CARE SYSTEM : LESSONS FOR NEWLY INDUSTRIALIZED COUNTRIES.

E. Rodriguez, P. Gallo de Puelles and A. J. Jovell

Health Policy and Planning, vol. 14, 1999, p. 164-173

Summaries the organisation, financing and delivery of health care services in Spain, and discusses the elements that made it possible to maintain high levels of health among the population while spending comparatively less on the health care system than most industrialised countries.

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