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Welfare Reform on the Web (November 1999): Health Care - Overseas

CLOSING RURAL HOSPITALS IN SASKATCHEWAN: ON THE ROAD TO WELLNESS?

A M James

Social Science and Medicine, vol. 49, 1999, p. 1021-1034

As part of its 'wellness' approach to health, the Saskatchewan government in 1992 announced the closure and conversion of 52 small rural hospitals to wellness centres as part of a shift from institutional care to community based care. While the health costs and benefits of this shift are contested, closing rural hospitals may have unrealised social and health and health costs because of the psychological importance of these hospitals to the community.

COMMUNITY DEVELOPMENT THROUGH PARTNERSHIP: PROMOTING HEALTH IN AN URBAN INDIGENOUS COMMUNITY IN NEW ZEALAND

J A Voyle and D Simmons

Social Science and Medicine, vol. 49, 1999, p. 1035-1050

Paper focuses on the formation of partnerships between professionals and community groups as a way of promoting community development. Drawing upon a detailed literature review and data from the health promotion project evaluation, paper offers a list of recommended procedures for the development of partnerships applicable to health and other domains. Recommendations encompass preparatory steps, the formation of a partnership committee, programme planning and development and the appointment of a community based liaison worker. The recommended procedures are intended to illustrate how individual and community empowerment can be incorporated in the operation of partnerships.

EQUITY IN HEALTH AND HEALTH CARE: THE CHINESE EXPERIENCE

Y Liu, W C Hsaio and K Eggleston

Social Science and Medicine, vol. 49, 1999, p. 1349-1356

Empirical evidence suggests a widening gap in health status between urban and rural residents in China during the transition from a command economy to a market economy. This gap correlated with increasing inequality in income and health care utilization. These trends are associated with changes in health care financing and organization, including dramatic reduction in insurance cover of the rural population. The Chinese experience demonstrates that health improvement does not automatically follow economic growth.

THE IMPACT OF PUBLIC SPENDING ON HEALTH: DOES MONEY MATTER?

D Filmer and L Pritchett

Social Science and Medicine, vol. 49, 1999, p. 1309-1323

Uses cross-national data to examine the impact of public spending on health on health status. Results show that the impact of public spending on health is quite small. Independent variation in public spending explains less than one-seventh of 1% of the observed differences in mortality across countries. While health spending is not a powerful determinant of mortality, 95% of cross-national variation in mortality can be explained by a country's income per capita, inequality of income distribution, extent of female education, level of ethnic fragmentation and predominant religion.

OZ TRIALS

P West

Health Service Journal, vol. 109, August 19th 1999, p. 24-25

Privatisation of a public sector general hospital in Adelaide, Australia, five years ago has revealed both the strengths of the model and the difficulties of contracting with the private sector. Managers believe the new model has reduced overstaffing and local management input. However, there have been continual contracting problems and the hospital has made losses almost from the start.

STATE OF THE UNION

H Berliner

Health Service Journal, vol. 109, August 12th 1999, p. 27

Reports that the American Medical Association has announced its intention to form a national union for doctors. This move arises from frustration at the loss of autonomy suffered by the medical profession through its dealings with health insurance companies and at the restrictions placed on the activities of doctors by managed care companies.

WARY REPUBLICANS BACK HEALTH PLAN LAWSUITS

D McGregor

Financial Times, Sept. 10th 1999, p. 3

Reports introduction of a bill into the House by two Conservative Republicans that would grant some patients the right to sue their health plans.

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