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Welfare Reform on the Web (March 2005): Healthcare - Overseas

DRUG COVERAGE IN CANADA: WHO IS AT RISK?

V. Kapur and K. Basu

Health Policy, vol.71, 2005, p.181-193

Every Canadian has free access to physician and hospital services, but not all are covered for prescription drugs. Coverage for prescription drugs may be available to Canadians as part of their employment benefits. Provincial governments provide coverage for the poor and elderly. Two recent reports on healthcare in Canada focus on the need to help families with the cost of drugs. Article seeks to provide a fact base for policymakers designing government drug insurance programmes by analysing the current extent and quality of coverage. It relates coverage, or the lack of it, to the actual out-of-pocket expenses that Canadians have to pay to procure medically necessary drugs.

MAJOR ISSUES RELATING TO END-OF-LIFE CARE: ETHICAL, LEGAL AND MEDICAL FROM A HISTORICAL PERSPECTIVE

R.F. Rizzo

International Journal of Social Economics, vol.32, 2005, p.34-59

Article analyses the development of statute and case law relating to active euthanasia, assisted suicide and passive euthanasia (withdrawal or withholding of life-sustaining measures) in the USA. It finds that there are still problems in applying ethical and legal principles to specific cases which are complicated by poor patient-doctor communication, the ineffective use of advance directives, and the impact of the market economy on comprehensive palliative care. These problems call for reform to protect personal rights and dignity at the end of life.

OUTSOURCING IN THE AUSTRALIAN HEALTH SECTOR: THE INTERPLAY OF ECONOMICS AND POLITICS

S. Young

International Journal of Public Sector Management, vol.18, 2005, p.25-36

Article explores different approaches to outsourcing by three Australian health organisations responding to government policy. Specific decisions on areas to be outsourced were made on the basis of the characteristics of the labour market, including employee skills levels and the availability of labour, the nature of industrial relations, the perception of what is core in relation to patient care, and a desire to get rid of obstructive middle management. Cost savings and increases in efficiency resulted from outsourcing, alongside a downsized labour force. However, where outsourcing did not proceed, similar results were obtained from the introduction of new technology, restructuring and the promotion of workforce flexibility.

PATIENT SAFETY: HOW MUCH IS ENOUGH?

R.N. Warburton

Health Policy, vol.71, 2005, p.223-232

Hospitals in Canada have been inundated with recommendations and requirements for improving patient safety from government and other sources. Yet little guidance is available on the relative priority of various changes, and the costs and effects of improvements have not been studied. There is a need to collect and use cost-effectiveness evidence both to prioritise proposed safety improvements and to target new research. Paper proposes a method to generate the necessary evidence.

SOCIAL HEALTH INSURANCE: KEY FACTORS AFFECTING THE TRANSITION TOWARDS UNIVERSAL COVERAGE

G. Carrin and C. James

International Social Security Review, vol.58, Jan.-Mar. 2005, p.45-64

Several low- and middle-income countries are interested in extending their existing health insurance for specific groups to eventually cover their entire population. Article analyses the experience of eight countries which have made the transition to universal coverage via social health insurance. Goes on to discuss the facilitating factors which speed the transition to universal coverage, including the level of income, structure of the economy, distribution of the population, ability to administer and level of solidarity within the country.

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