Click here to skip to content

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

'Assassin!': AIDS and neoliberal reform in France

M.J. Bosia

New Political Science, vol.27, 2005, p.291-308

In 1999 French former Prime Minister Laurent Fabius and two of his ministers were put on trial for involuntary homicide for allowing blood products infected with the HIV virus to be used by haemophiliacs and for transfusions in the 1980s. HIV activists (gays, haemophiliacs and blood transfusion recipients) argued that government cost cutting and the implementation of a neoliberal austerity programme in 1984 had led to delays in the implementation of AIDS prevention measures and to the state failing in its duty to protect citizens from the epidemic.

A comparative analysis of drug safety withdrawals in the UK and the US (1971-1992): implication for current regulatory thinking and policy

J. Abraham and C. Davis

Social Science and Medicine, vol. 61, 2005, p.881 - 892

It is likely that the speeding up of drug regulatory review times is compromising drug safety. This paper reports on an investigation into why double the number of new prescription drugs were withdrawn from the market in the UK as were withdrawn in the US over a 20 year period. Previously unreleased regulatory data and interviews with regulators and industry are used to analyse five hypotheses, and authors conclude that US regulatory checks took longer to process than the quicker UK system which let higher numbers of unsafe drugs enter the market.

Creating demand for sanitation and hygiene through Community Health Clubs: a cost-effective intervention in two districts in Zimbabwe

J. Waterkeyn and S. Cairncross

Social Science and Medicine, vol.61, 2005, p.1958-1970

Study describes the use of Community Health Clubs in the Makoni and Tsholotsho districts of Zimbabwe to change hygiene behaviour and build rural demand for sanitation. Within two years, 2400 latrines had been built in Makoni and in Tsholotsho latrine coverage rose to 43% compared to 2% in the control area, with 1200 latrines being built in 18 months. Club members' hygiene was significantly different from a control group across 17 key practices including hand washing, showing that if a strong community structure is developed and the norms of a community are altered, sanitation and hygiene behaviour are likely to improve. This methodology could be scaled up to contribute to ambitious global targets.

Explicit rationing of elective services: implementing the New Zealand reforms

K. Dew and others

Health Policy, vol.74, 2005, p.1-12

In an attempt to make rationing of elective surgery in the publicly funded health care system explicit and more transparent, New Zealand introduced a booking system for surgery using clinical priority assessment criteria (CPAC). In the context of limited resources, the aim was to give priority to the patients most likely to benefit from surgery. To explore whether the goals of explicit rationing were being met, 69 interviews were undertaken with policy advisors, administrators and clinicians in six locations throughout New Zealand. Results show that the move towards explicit rationing has changed the way in which patients access surgery. However, clinical judgement in assessing capacity to benefit from surgery and the continuing ability for the booking system to be gamed mean that implicit rationing is still a factor in determining access to elective surgery.

Global trade, public health, and health services: stakeholders’ constructions of the key issues

H.Waitzkin and others

Social Science and Medicine, vol. 61, 2005, p.893 - 906

Widely divergent constructions of the social reality of trade and health service provision exist between and amongst stakeholder groups who contribute to the policy debate on the poorly understood links between these policy areas. Reporting from qualitative research, this paper analyses constructs, revealing differing ideologies and creeds regarding, for example, intellectual property, health as a public good, the role of the market and its consequences. Stakeholder groups are: US and Latin American government agencies, international finance and trade organisations, multinational corporations and advocacy groups.

Globalization, social policy and the state: an analysis of HIV/AIDS in South Africa

K. Johnson

New Political Science, vol.27, 2005, p.309-329

The post-Apartheid South African government in the 1990s redefined AIDS as a disease of poverty rather than a sexually transmitted infection, thereby highlighting the patterns of underdevelopment and dependence between Africa and the West that have been exacerbated by the processes of economic globalisation. Unfortunately while focusing on this strategic approach, it failed to put in place practical measures to halt the spread of the disease such as sex education and funding of anti-retroviral drugs for sufferers.

Health care in the social development context: indigenous, participatory and empowering approaches

M. Julia and M.E. Kondrat

International Social Work, vol.48, 2005, p.537-552

Because of the recognised connection between health and social development, social development scholars and practitioners have advocated more indigenous and participatory approaches in conducting health assessments and in the delivery of health programmes of relevance to individuals, families and communities. This article presents a rationale for participatory and local approaches. The arguments are illustrated by case studies of participatory approaches to primary and rehabilitative health care drawn from Central America and South India.

Inequity in the price of physician activity across surgical procedures

K. Hayashida and Y. Imanaka

Health Policy, vol.74, 2005, p.24-38

The Japanese government has undertaken a review of the reimbursement system for healthcare professionals in an effort to identify the factors which drive hospital and physician fees-for-service. The goal is to introduce a rational payment system which reflects the difficulty of the surgical procedure and the time and technical skill required. Study examined the current surgical reimbursement system in Japan using a cost accounting scheme and actual data. Concludes with recommendations on how the system could be reformed to achieve the government's goals.

Interorganizational collaboration for health care between nongovernmental organizations (NGOs) in Pakistan

L. Gulzar and B. Henry

Social Science and Medicine, vol.61, 2005, p.1930-1943

In Pakistan a weak health system and little collaboration limits access to services, especially for women and children. Many NGOs provide health care to the very poor and some appear to collaborate to varying degrees, but this has not been systematically analysed. This qualitative study, the first of its kind, describes collaboration between three pairs of NGOs providing community-based healthcare to women in Karachi. Findings indicate that collaboration is strongest when there is a willingness to cooperate, trust is built and effective personal relationships are sustained. In Pakistan's complex social environment, collaboration tends to be stronger when there is fairly high organisational formalisation. Broader interorganisational collaboration appears to be associated with better access to health care for women.

Medicaid programme changes and the chronically ill: early results from a prospective cohort study of the Oregon Health Plan

R. Solotaroff and others

Chronic Illness, vol.1, 2005, p.191-205

In early 2003 the Oregon Health Plan (OHP) implemented cost-sharing policies and reduced benefits for many adult members in order to reduce expenditure. Results of a postal survey of 1374 OHP participants directly affected by the new policies showed a significant association between the changes and disenrolment. Compared to the non-chronically ill, the chronically ill were more likely to report inability to pay for medicines, higher medical debt, more unmet health needs, and poorer health status. Among the chronically ill, those who lost insurance reported decreased access to and utilisation of health care, more medical debt, and more restriction of medications.

Search Welfare Reform on the Web