Welfare Reform on the Web (October 2004): Healthcare - Overseas

"BRAIN DRAIN" OF HEALTH PROFESSIONALS: FROM RHETORIC TO RESPONSIBLE ACTION

T. Martineau, K. Decker and P. Bundred

Health Policy, Vol.70, 2004, p. 1-10

As large scale movement of health professionals from developing countries is now impacting adversely on their health systems, a meaningful dialogue needs to take place among stakeholders to seek out solutions. The paper focuses on the responsibilities of importing countries and exporting countries as well as responsibilities at the global level. It draws on an exploratory study carried out in Ghana, South Africa and England.

CAN COMMUNITY HEALTH INSURANCE SCHEMES SHIELD THE POOR AGAINST THE DOWNSIDE HEALTH EFFECTS OF ECONOMIC REFORMS? THE CASE OF RURAL ETHIOPIA

A. Asfaw and J. von Braun

Health Policy, Vol.70, 2004, p.97-108

The study investigates the prospects of Community Based Health Insurance Schemes (CBHIS) mitigating the adverse health effects of economic liberalisation and globalisation. It uses household level data collected from rural areas of Ethiopia and double-bounded dichotomous choice contingent valuation method to examine the prospect of CBHIS shielding the poor against the adverse effects of economic reform and deregulation. Results demonstrated that the introduction of such schemes can help to prevent the eviction of the poor and disadvantaged from the health care marker.

FRENCH LESSONS ON FUNDING THE FUTURE

T. Harvey

British Journal of Heath Care Management, Vol.10 2004, p.186-187

The article critically reviews France's healthcare funding system and argues that the NHS might benefit from looking more closely at how its European neighbours attempt to solve their funding problems.

FUNCTIONING OF FAMILY NURSING IN TRANSITION: AN EXAMPLE OF A SMALL TOWN IN POLAND. ARE THERE ANY BENEFITS FOR PATIENTS?

L. Marcinowicz and S. Chlabicz

Health Expectations, Vol.7, 2004, p.203-208

Study aimed to compare patients' views on selected aspects of the quality of family nursing in Poland in 1998 and 2002. In the intervening period the organisational and legal form of family nursing services had changed. In 1998, the majority of family nurses were employed by family physicians or public health institutions. By 2002 many nurses had established independent practices and signed direct contracts with the National Health Fund. Results of the two surveys showed that family nurse care was available to more patients in 2002 than in 1998 and patients were more satisfied with family nurses working as independent contractors.

HEALTHCARE FUNDING PROBLEMS IN ALGERIA

N. Kaid Tlilane

International Social Security Review, Vol.57, Oct-Dec 2004, p.91-110

Healthcare in Algeria is funded by a mixture of social insurance, general taxation and co-payment by users. However, funds available are not sufficient to cover the costs of medical equipment, drugs and health staff, so that the healthcare needs of the population are not being met.

MAKING SENSE OF SOCIAL CAPITAL, HEALTH AND POLICY

S.E.D. Shortt

Health Policy, Vol.70, 2004, p.11-22

The paper summarises current knowledge about social capital and its implications for health policy formulation. It reviews the existing literature in order to:

• describe the definition and use of the concept of social capital in the social sciences;
• explore theoretical critiques of the concept and measurement issues;
• document the application of the concept to health research;
• assess the manner in which social capital may prove relevant to health policy formation.

MEDICAL SAVINGS ACCOUNTS IN A UNIVERSAL SYSTEM: WISHFUL THINKING MEETS EVIDENCE

R.B. Deber, E.L. Forget and L.B. Roos

Health Policy, Vol.70, 2004, p.49-66

Medical Savings Accounts (MSAs) for individuals are increasingly being proposed as an innovative mechanism to finance healthcare within systems of universal coverage. However, data from Manitoba suggest that substituting MSAs for the current methods of financing hospitals and physician services would substantially increase public health expenditure unless health insurance coverage is cut dramatically. No feasible method of tailoring MSAs to individual needs on the basis of age, sex, income and health status can eliminate this cost increase if all members of the population are to be covered.

PERCEPTIONS AROUND CONCORDANCE: FOCUS GROUPS AND SEMI-STRUCTURED INTERVIEWS CONDUCTED WITH CONSUMERS, PHARMACISTS AND GENERAL PRACTITIONERS.

J. Bajramovic, L. Emmerton and S.E. Tett

Health Expectations, Vol.7, 2004, p.221-234

Concordance is an agreement or partnership between the patient and the prescriber about obtaining the best use of treatment, compatible with what the patient desires and is capable of achieving. Achieving concordance between health professionals and patients by identifying beliefs about illness, treatment and medicine taking and giving patients the opportunity to be involved in decision-making should impact positively on behaviour with respect to treatment. There was general agreement among participants in this Australian study that better information sharing and more time for discussion would lead to concordance.

A STRONGER ROLE FOR THE PRIVATE SECTOR IN FRANCE'S HEALTH INSURANCE

P. Turquet

International Social Security Review, Vol.57, Oct.-Dec. 2004, p.67-89

Social Security in France funds the costs of medical goods and services up to a maximum of 75.5% with users paying the rest out of their own pockets. Complementary cover can be obtained from private insurers, but this gives rise to numerous inequalities in terms of access and content. The health insurance reforms scheduled for 2004 may allow private insurers to play a greater role in funding health costs at the expense of weakened national solidarity.