Chrisanthi Avgerou
- Published in print:
- 2003
- Published Online:
- September 2007
- ISBN:
- 9780199263424
- eISBN:
- 9780191714252
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199263424.003.0009
- Subject:
- Business and Management, Organization Studies
This chapter examines information systems for the use of medical drugs, known as drug utilization systems, also referred to as prescription systems in the UK. Since the 1980s, information systems in ...
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This chapter examines information systems for the use of medical drugs, known as drug utilization systems, also referred to as prescription systems in the UK. Since the 1980s, information systems in the US and Europe that monitor drug utilization and influence doctors’ prescribing behaviour acquired great significance, due to the increased costs of drug treatments and the problem of cost containment faced by healthcare organizations. By outlining what drug utilization systems have been implemented in the US and the UK — two countries with very different healthcare systems and both experiencing reform pressures — this case study shows two things. First, how different information systems emerge in healthcare systems organized according to different principles of rationality. Second, how, even in the same country and organizational setting, information systems are confronted with different and competing substantive rationalities. In this case, economic management, equitable high-quality public service, and science-based professional conduct.Less
This chapter examines information systems for the use of medical drugs, known as drug utilization systems, also referred to as prescription systems in the UK. Since the 1980s, information systems in the US and Europe that monitor drug utilization and influence doctors’ prescribing behaviour acquired great significance, due to the increased costs of drug treatments and the problem of cost containment faced by healthcare organizations. By outlining what drug utilization systems have been implemented in the US and the UK — two countries with very different healthcare systems and both experiencing reform pressures — this case study shows two things. First, how different information systems emerge in healthcare systems organized according to different principles of rationality. Second, how, even in the same country and organizational setting, information systems are confronted with different and competing substantive rationalities. In this case, economic management, equitable high-quality public service, and science-based professional conduct.
Alain Enthoven
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780195390131
- eISBN:
- 9780199775934
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195390131.003.004
- Subject:
- Law, Medical Law
This chapter begins with a discussion of the fragmentation of health care delivery and its occurrence at two levels: with the individual patient, and at the community level. It then discusses ...
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This chapter begins with a discussion of the fragmentation of health care delivery and its occurrence at two levels: with the individual patient, and at the community level. It then discusses integrated and coordinated health care delivery systems. It is argued that America could move rapidly to integrated systems if it “opens the markets and levels the playing field” by adopting a reform model like the Wyden–Bennett Healthy Americans Act, the Dutch model, or the one proposed by the Committee for Economic Development (CED), in which everyone would have wide, responsible, individual, and informed choice, and multiple choices among alternative health care financing and delivery systems. Experience shows that when offered such a choice, great majorities of people choose integrated systems. The principles of such reforms are comparatively easy to state. The implementation is, unfortunately, extremely complex.Less
This chapter begins with a discussion of the fragmentation of health care delivery and its occurrence at two levels: with the individual patient, and at the community level. It then discusses integrated and coordinated health care delivery systems. It is argued that America could move rapidly to integrated systems if it “opens the markets and levels the playing field” by adopting a reform model like the Wyden–Bennett Healthy Americans Act, the Dutch model, or the one proposed by the Committee for Economic Development (CED), in which everyone would have wide, responsible, individual, and informed choice, and multiple choices among alternative health care financing and delivery systems. Experience shows that when offered such a choice, great majorities of people choose integrated systems. The principles of such reforms are comparatively easy to state. The implementation is, unfortunately, extremely complex.
Frank Pasquale
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780195390131
- eISBN:
- 9780199775934
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195390131.003.011
- Subject:
- Law, Medical Law
This chapter focuses on the need for more targeted assessment of the impact of market forces on communities. Pilot programs encourage experimentation in the delivery system without risking widespread ...
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This chapter focuses on the need for more targeted assessment of the impact of market forces on communities. Pilot programs encourage experimentation in the delivery system without risking widespread disruption of care for the uninsured and emergency services. The Center for Medicare & Medicaid Services (CMS) has already embraced the idea of pilot programs in other contexts, and they could be especially appropriate if specialty hospitals were permitted in markets where general hospitals had a demonstrably poor record of community service. In such markets, cross-subsidization is probably already low, and specialty hospital threats to it are not as much of a concern as they are in areas where general hospitals consistently serve a substantial base of indigent and uninsured patients. Part II of the chapter makes the case for pilot programs by laying out basic facts about the current performance of specialty hospitals. Part III describes the increasingly complex legal landscape surrounding them—including directly applicable provisions of state and federal laws, and incumbent hospitals' strategies to deploy other regulations, statutes, and common law to gain competitive advantage. After briefly describing the drawbacks of all these strategies, Part IV advances the positive contribution of the chapter: a turn to pilot programs that would promote an evidence-based response to the rise of specialty hospitals.Less
This chapter focuses on the need for more targeted assessment of the impact of market forces on communities. Pilot programs encourage experimentation in the delivery system without risking widespread disruption of care for the uninsured and emergency services. The Center for Medicare & Medicaid Services (CMS) has already embraced the idea of pilot programs in other contexts, and they could be especially appropriate if specialty hospitals were permitted in markets where general hospitals had a demonstrably poor record of community service. In such markets, cross-subsidization is probably already low, and specialty hospital threats to it are not as much of a concern as they are in areas where general hospitals consistently serve a substantial base of indigent and uninsured patients. Part II of the chapter makes the case for pilot programs by laying out basic facts about the current performance of specialty hospitals. Part III describes the increasingly complex legal landscape surrounding them—including directly applicable provisions of state and federal laws, and incumbent hospitals' strategies to deploy other regulations, statutes, and common law to gain competitive advantage. After briefly describing the drawbacks of all these strategies, Part IV advances the positive contribution of the chapter: a turn to pilot programs that would promote an evidence-based response to the rise of specialty hospitals.
Mark Schlesinger
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195170665
- eISBN:
- 9780199850204
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195170665.003.0024
- Subject:
- Political Science, American Politics
This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes ...
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This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes that have dramatically altered the politics of inequality in medical care. First, the introduction of markets to medical care exacerbates unequal health outcomes. Long-standing differences in health-care utilization and health outcomes are likely to grow under market reforms. Second, market arrangements promoted the growth of large health-care corporations. Their political power may circumscribe government policy making that could limit health inequalities. Third, market frames are associated with different standards of fairness for assessing the performance of the health-care system. This changes the outcomes seen as inequitable, and hence suitable, for government intervention. Fourth, market schemas have transformed prevailing discourse around important perspectives on health policy, including the rights of citizens and the responsibilities of local communities.Less
This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes that have dramatically altered the politics of inequality in medical care. First, the introduction of markets to medical care exacerbates unequal health outcomes. Long-standing differences in health-care utilization and health outcomes are likely to grow under market reforms. Second, market arrangements promoted the growth of large health-care corporations. Their political power may circumscribe government policy making that could limit health inequalities. Third, market frames are associated with different standards of fairness for assessing the performance of the health-care system. This changes the outcomes seen as inequitable, and hence suitable, for government intervention. Fourth, market schemas have transformed prevailing discourse around important perspectives on health policy, including the rights of citizens and the responsibilities of local communities.
Rebecca J. Cook, Bernard M. Dickens, and Mahmoud F. Fathalla
- Published in print:
- 2003
- Published Online:
- October 2011
- ISBN:
- 9780199241323
- eISBN:
- 9780191696909
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199241323.003.0003
- Subject:
- Philosophy, Moral Philosophy
This chapter defines a health care system as the mechanism in any society that transforms or metabolizes inputs of knowledge, and human and financial resources into outputs of services relevant to ...
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This chapter defines a health care system as the mechanism in any society that transforms or metabolizes inputs of knowledge, and human and financial resources into outputs of services relevant to the health concerns in that society. It emphasizes that the promotion of health is not the domain of the health care system alone, since other social systems bear upon the effective, humane, and equitable operation of the health system in each society.Less
This chapter defines a health care system as the mechanism in any society that transforms or metabolizes inputs of knowledge, and human and financial resources into outputs of services relevant to the health concerns in that society. It emphasizes that the promotion of health is not the domain of the health care system alone, since other social systems bear upon the effective, humane, and equitable operation of the health system in each society.
GERMANO MWABU
- Published in print:
- 2001
- Published Online:
- October 2011
- ISBN:
- 9780199242191
- eISBN:
- 9780191697050
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199242191.003.0010
- Subject:
- Economics and Finance, Development, Growth, and Environmental, Public and Welfare
Efficiency and equity have been the most controversial concerns in the health care financial system for a very long time, specifically in most low-income countries. Since there are informational and ...
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Efficiency and equity have been the most controversial concerns in the health care financial system for a very long time, specifically in most low-income countries. Since there are informational and organisational conflicts, markets that provide health services might not be possible and may not be able to address the precautionary measures and the necessary short- and long-term support. It can be inferred that health care design should consider several areas such as the assertion that the price system offers theoretical explanations for user fees in the market's health industry, the efficient use of market mechanisms, the importance of medical assistance's price elasticity of demand in the execution of user fees in developing nations, and the correlation between the funding of medical support and the economic indicators.Less
Efficiency and equity have been the most controversial concerns in the health care financial system for a very long time, specifically in most low-income countries. Since there are informational and organisational conflicts, markets that provide health services might not be possible and may not be able to address the precautionary measures and the necessary short- and long-term support. It can be inferred that health care design should consider several areas such as the assertion that the price system offers theoretical explanations for user fees in the market's health industry, the efficient use of market mechanisms, the importance of medical assistance's price elasticity of demand in the execution of user fees in developing nations, and the correlation between the funding of medical support and the economic indicators.
Jill Quadagno
- Published in print:
- 2006
- Published Online:
- May 2012
- ISBN:
- 9780195160390
- eISBN:
- 9780199944026
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195160390.003.0009
- Subject:
- Sociology, Race and Ethnicity
This chapter presents an evaluation of the alternative explanations of the American case based on the historical evidence given, and analyzes the prospects of health care reform in the twentieth ...
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This chapter presents an evaluation of the alternative explanations of the American case based on the historical evidence given, and analyzes the prospects of health care reform in the twentieth century. It also argues that the United States does not have the health care system it needs due to the failure of its citizens to realize how much they have ceded their health care to private interests, and also reviews the theories of the welfare state.Less
This chapter presents an evaluation of the alternative explanations of the American case based on the historical evidence given, and analyzes the prospects of health care reform in the twentieth century. It also argues that the United States does not have the health care system it needs due to the failure of its citizens to realize how much they have ceded their health care to private interests, and also reviews the theories of the welfare state.
João Biehl and Adriana Petryna
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691157382
- eISBN:
- 9781400846801
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691157382.003.0016
- Subject:
- Anthropology, Social and Cultural Anthropology
In 1996, Brazil became the first developing country to adopt an official policy granting free access to antiretroviral drugs through its broad-reaching but ailing public health care system (SUS). In ...
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In 1996, Brazil became the first developing country to adopt an official policy granting free access to antiretroviral drugs through its broad-reaching but ailing public health care system (SUS). In the wake of the country's highly publicized antiretroviral drug rollout, public health and care have become increasingly pharmaceuticalized and privatized, and the rights-based demand for drug access has migrated from AIDS to other diseases and patient groups. A growing number of citizens are acting within the state to guarantee their right to health, understood as access to medicines of all kinds, whether or not they are available in official drug formularies. This chapter examines the political subjects that emerge from this complex law–state–market ecology and shows how in this new chapter in the history of the right to health, the judiciary has become a crucial arbiter and purveyor of care and technology access.Less
In 1996, Brazil became the first developing country to adopt an official policy granting free access to antiretroviral drugs through its broad-reaching but ailing public health care system (SUS). In the wake of the country's highly publicized antiretroviral drug rollout, public health and care have become increasingly pharmaceuticalized and privatized, and the rights-based demand for drug access has migrated from AIDS to other diseases and patient groups. A growing number of citizens are acting within the state to guarantee their right to health, understood as access to medicines of all kinds, whether or not they are available in official drug formularies. This chapter examines the political subjects that emerge from this complex law–state–market ecology and shows how in this new chapter in the history of the right to health, the judiciary has become a crucial arbiter and purveyor of care and technology access.
Anne-Emanuelle Birn, Yogan Pillay, and Timothy H. Holtz
- Published in print:
- 2017
- Published Online:
- March 2017
- ISBN:
- 9780199392285
- eISBN:
- 9780199392315
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199392285.003.0011
- Subject:
- Public Health and Epidemiology, Epidemiology
This chapter examines archetypes of health care systems, from various European national health systems to the centrally planned model of the former Soviet Union and the market-driven US model. The ...
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This chapter examines archetypes of health care systems, from various European national health systems to the centrally planned model of the former Soviet Union and the market-driven US model. The chapter then analyzes two key health care policy approaches: primary health care and universal health coverage. It provides illustrations of recent and ongoing health system reforms across all world regions (covering China, Thailand, the Middle East, Brazil, Mexico, South Africa, South Korea, and India) that address—to varying degrees—questions of regulation, financing, resource allocation, the nature of service provision, and principles of universality, access, affordability, quality, and equity within the politics of their context. In addition, it provides an overview of the building blocks of health care systems including facilities, different types of health care personnel, problems around health workforce migration, technology, and the powerful role of the pharmaceutical industry.Less
This chapter examines archetypes of health care systems, from various European national health systems to the centrally planned model of the former Soviet Union and the market-driven US model. The chapter then analyzes two key health care policy approaches: primary health care and universal health coverage. It provides illustrations of recent and ongoing health system reforms across all world regions (covering China, Thailand, the Middle East, Brazil, Mexico, South Africa, South Korea, and India) that address—to varying degrees—questions of regulation, financing, resource allocation, the nature of service provision, and principles of universality, access, affordability, quality, and equity within the politics of their context. In addition, it provides an overview of the building blocks of health care systems including facilities, different types of health care personnel, problems around health workforce migration, technology, and the powerful role of the pharmaceutical industry.
Matthew Rizzo, Sean McEvoy, and John Lee
- Published in print:
- 2006
- Published Online:
- May 2009
- ISBN:
- 9780195177619
- eISBN:
- 9780199864683
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195177619.003.0023
- Subject:
- Neuroscience, Sensory and Motor Systems, Behavioral Neuroscience
This chapter considers how neuroergonomics—the study of the brain and behavior at work in healthy and impaired states—is relevant to assessments and interventions in patient safety at the levels of ...
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This chapter considers how neuroergonomics—the study of the brain and behavior at work in healthy and impaired states—is relevant to assessments and interventions in patient safety at the levels of individuals and health care systems. It reviews potential areas for neuroergonomic interventions at the level of individuals and systems, and cultural and legal issues that affect the ability to intervene.Less
This chapter considers how neuroergonomics—the study of the brain and behavior at work in healthy and impaired states—is relevant to assessments and interventions in patient safety at the levels of individuals and health care systems. It reviews potential areas for neuroergonomic interventions at the level of individuals and systems, and cultural and legal issues that affect the ability to intervene.
David A. Leon and Gill Walt
- Published in print:
- 2000
- Published Online:
- September 2009
- ISBN:
- 9780192631961
- eISBN:
- 9780191723599
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192631961.003.0009
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter considers the role of health care systems in generating poverty and inequality. It argues that health care systems, as social institutions, are built out of the existing social structure ...
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This chapter considers the role of health care systems in generating poverty and inequality. It argues that health care systems, as social institutions, are built out of the existing social structure and carry its inequalities within them. However, health care systems are also a key site for contestation of existing inequality: they offer a representation back to us of our societies' capacity for care, and a public space for reworking those capacities. Effective health care reform that seeks to make the social institutions of health care more equitable must draw from an effective theory of health care system/inequality interaction. An approach to conceptualizing health care reform is presented.Less
This chapter considers the role of health care systems in generating poverty and inequality. It argues that health care systems, as social institutions, are built out of the existing social structure and carry its inequalities within them. However, health care systems are also a key site for contestation of existing inequality: they offer a representation back to us of our societies' capacity for care, and a public space for reworking those capacities. Effective health care reform that seeks to make the social institutions of health care more equitable must draw from an effective theory of health care system/inequality interaction. An approach to conceptualizing health care reform is presented.
Markus A. Feufel, Gerd Antes, Johann Steurer, Gerd Gigerenzer, J. A. Muir Gray, Marjukka Mäkelä, Albert G. Mulley, David E. Nelson, Jay Schulkin, Holger Schünemann, John E. Wennberg, and Claudia Wild
- Published in print:
- 2011
- Published Online:
- May 2016
- ISBN:
- 9780262016032
- eISBN:
- 9780262298957
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262016032.003.0008
- Subject:
- Psychology, Health Psychology
Patients’ health illiteracy is, in part, a consequence of how the health care system has been set up. Conversely, the flaws of the health care system and the interest groups it caters to can only ...
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Patients’ health illiteracy is, in part, a consequence of how the health care system has been set up. Conversely, the flaws of the health care system and the interest groups it caters to can only exist to the degree that patients remain uninformed. Thus, to improve health care, two strategies are presented. The first involves changing the health care system by introducing new, and enforcing existing, guidelines and procedures designed to reduce funding and reporting biases as well as financial conflicts of interests. If a health care system can be freed of these problems, patients, independent of their health literacy level, will be able to get good health care, simply by trusting their doctor and the information provided. The second requires educating the public to increase knowledge about how their health care system works (health system literacy). If patients become more health system literate, they will be able to identify if and why evidence is missing, incomplete, or unreliable and will get better health care because they are not easily misled by nonmedical interests acting within their health care system.Less
Patients’ health illiteracy is, in part, a consequence of how the health care system has been set up. Conversely, the flaws of the health care system and the interest groups it caters to can only exist to the degree that patients remain uninformed. Thus, to improve health care, two strategies are presented. The first involves changing the health care system by introducing new, and enforcing existing, guidelines and procedures designed to reduce funding and reporting biases as well as financial conflicts of interests. If a health care system can be freed of these problems, patients, independent of their health literacy level, will be able to get good health care, simply by trusting their doctor and the information provided. The second requires educating the public to increase knowledge about how their health care system works (health system literacy). If patients become more health system literate, they will be able to identify if and why evidence is missing, incomplete, or unreliable and will get better health care because they are not easily misled by nonmedical interests acting within their health care system.
Ellen Kuhlmann
- Published in print:
- 2006
- Published Online:
- March 2012
- ISBN:
- 9781861348586
- eISBN:
- 9781447302810
- Item type:
- book
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781861348586.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
This book is a crucial contribution to debates about the rapid modernisation of health care systems and the dynamics of changing modes of governance and citizenship. Structured around the role of the ...
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This book is a crucial contribution to debates about the rapid modernisation of health care systems and the dynamics of changing modes of governance and citizenship. Structured around the role of the professions as mediators between state and citizens, and set against a background of tighter resources and growing demands for citizenship rights, the book offers a much-needed comparative analysis, using the German health care system as a case study. The German system, with its strongly self-regulatory medical profession, exemplifies both the capacity of professionalism to re-make itself, and the role of the state in response, highlighting the benefits and dangers of medical self-regulation, while demonstrating the potential for change beyond marketisation and managerialism. The book critically reviews dominant models of provider control and user participation, and empirically investigates different sets of dynamics in health care, including tensions between global reform models and nation-specific conditions; inter-professional dynamics and changing gender arrangements; the role of the service-user as a new stakeholder in health care; and the rise of a new professionalism shaped by social inclusion. This book provides new approaches and a wealth of new empirical data.Less
This book is a crucial contribution to debates about the rapid modernisation of health care systems and the dynamics of changing modes of governance and citizenship. Structured around the role of the professions as mediators between state and citizens, and set against a background of tighter resources and growing demands for citizenship rights, the book offers a much-needed comparative analysis, using the German health care system as a case study. The German system, with its strongly self-regulatory medical profession, exemplifies both the capacity of professionalism to re-make itself, and the role of the state in response, highlighting the benefits and dangers of medical self-regulation, while demonstrating the potential for change beyond marketisation and managerialism. The book critically reviews dominant models of provider control and user participation, and empirically investigates different sets of dynamics in health care, including tensions between global reform models and nation-specific conditions; inter-professional dynamics and changing gender arrangements; the role of the service-user as a new stakeholder in health care; and the rise of a new professionalism shaped by social inclusion. This book provides new approaches and a wealth of new empirical data.
Carolyn Hughes Tuohy
- Published in print:
- 2009
- Published Online:
- October 2013
- ISBN:
- 9780300149838
- eISBN:
- 9780300155952
- Item type:
- chapter
- Publisher:
- Yale University Press
- DOI:
- 10.12987/yale/9780300149838.003.0003
- Subject:
- Political Science, Comparative Politics
This chapter uses the Canadian health policy experience to illuminate the conditions under which fundamental or incremental reform takes place. The chapter is organized as follows. The first section ...
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This chapter uses the Canadian health policy experience to illuminate the conditions under which fundamental or incremental reform takes place. The chapter is organized as follows. The first section briefly sets out the theoretical framework for thinking about the dynamics of change in the health care arena. The second reviews the organizational and financial structures of Canadian health care in the 1970–1995 period, and addresses in particular the themes of the 1996 Four Country Conference: managing change, consumer choice, and resource allocation. The third section assesses the system in the mid-2000s and notes what remains constant and what has changed between 1996 and 2008.Less
This chapter uses the Canadian health policy experience to illuminate the conditions under which fundamental or incremental reform takes place. The chapter is organized as follows. The first section briefly sets out the theoretical framework for thinking about the dynamics of change in the health care arena. The second reviews the organizational and financial structures of Canadian health care in the 1970–1995 period, and addresses in particular the themes of the 1996 Four Country Conference: managing change, consumer choice, and resource allocation. The third section assesses the system in the mid-2000s and notes what remains constant and what has changed between 1996 and 2008.
David J. Hunter
- Published in print:
- 2008
- Published Online:
- March 2012
- ISBN:
- 9781861349293
- eISBN:
- 9781447303855
- Item type:
- book
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781861349293.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
Health care systems across the world are in a state of permanent revolution as they struggle to cope with multiple pressures arising from changing demography, new technologies and limited resources. ...
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Health care systems across the world are in a state of permanent revolution as they struggle to cope with multiple pressures arising from changing demography, new technologies and limited resources. Focusing on the British NHS, this book looks at how it has coped with such pressures over its 60-year history and considers what the future holds. It explores the complexity of health policy and health services, offering a critical perspective on their development. The book offers a reassessment of successive reforms of the NHS and their cyclical nature.Less
Health care systems across the world are in a state of permanent revolution as they struggle to cope with multiple pressures arising from changing demography, new technologies and limited resources. Focusing on the British NHS, this book looks at how it has coped with such pressures over its 60-year history and considers what the future holds. It explores the complexity of health policy and health services, offering a critical perspective on their development. The book offers a reassessment of successive reforms of the NHS and their cyclical nature.
Robert I. Field
- Published in print:
- 2013
- Published Online:
- January 2014
- ISBN:
- 9780199746750
- eISBN:
- 9780199354528
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199746750.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
Private enterprise drives health care more pervasivelyin the United Statesthananywhere else in the developed world. To many people,thisis evidence of a resounding “free-market” success. However, ...
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Private enterprise drives health care more pervasivelyin the United Statesthananywhere else in the developed world. To many people,thisis evidence of a resounding “free-market” success. However, beneath the private veneer,the system also relies on a more influential but less visible player forindispensible support– the government. Public programs are of such foundational importance to American health care that they can be credited with creating the systemas it exists today. Private health care entrepreneurship actually representsa massive partnership between the public and private spheres. This book traces the role of seminal public programs in building four keyhealth care sectors into the financial powerhouses they are today - pharmaceuticals, hospitals, the medical profession, and private insurance. It followsthe history of each, recounts statistical trends in their growth, and illustrates with case studies the extensive impact of government policies. Beyond its accomplishments, health care’s public-private collaborationalso has its share of failings. In particular, public largess has spawned private sector behemoths that perennially lobby for regulatory favors and ever greater levels of support. This has helped to make American health care the most expensive in the world. Nevertheless, for better or worse, the government is the only entity with the resources and national perspective needed to create an infrastructure on which the system can rest. Its relationship with the private sector definesthe possibilities for meaningful reform, including prospects for the Obama plan. Calls to limit the government’s role would lead not to a more expansive system but to one that would wither away.Less
Private enterprise drives health care more pervasivelyin the United Statesthananywhere else in the developed world. To many people,thisis evidence of a resounding “free-market” success. However, beneath the private veneer,the system also relies on a more influential but less visible player forindispensible support– the government. Public programs are of such foundational importance to American health care that they can be credited with creating the systemas it exists today. Private health care entrepreneurship actually representsa massive partnership between the public and private spheres. This book traces the role of seminal public programs in building four keyhealth care sectors into the financial powerhouses they are today - pharmaceuticals, hospitals, the medical profession, and private insurance. It followsthe history of each, recounts statistical trends in their growth, and illustrates with case studies the extensive impact of government policies. Beyond its accomplishments, health care’s public-private collaborationalso has its share of failings. In particular, public largess has spawned private sector behemoths that perennially lobby for regulatory favors and ever greater levels of support. This has helped to make American health care the most expensive in the world. Nevertheless, for better or worse, the government is the only entity with the resources and national perspective needed to create an infrastructure on which the system can rest. Its relationship with the private sector definesthe possibilities for meaningful reform, including prospects for the Obama plan. Calls to limit the government’s role would lead not to a more expansive system but to one that would wither away.
Jill Quadagno
- Published in print:
- 2006
- Published Online:
- May 2012
- ISBN:
- 9780195160390
- eISBN:
- 9780199944026
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195160390.003.0005
- Subject:
- Sociology, Race and Ethnicity
This chapter discusses how Medicaid and Medicare created uncontrollable inflation within the health care system, thus leading to a purchaser's revolt, first studying how the beneficiaries were ...
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This chapter discusses how Medicaid and Medicare created uncontrollable inflation within the health care system, thus leading to a purchaser's revolt, first studying how the beneficiaries were notified, before focusing on the implementation of Medicaid and of Parts A and B of Medicare. It also shows how costs were controlled in the health care sector.Less
This chapter discusses how Medicaid and Medicare created uncontrollable inflation within the health care system, thus leading to a purchaser's revolt, first studying how the beneficiaries were notified, before focusing on the implementation of Medicaid and of Parts A and B of Medicare. It also shows how costs were controlled in the health care sector.
Jill Quadagno
- Published in print:
- 2006
- Published Online:
- May 2012
- ISBN:
- 9780195160390
- eISBN:
- 9780199944026
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195160390.003.0004
- Subject:
- Sociology, Race and Ethnicity
This chapter explains how the radical politics of the South were enacted within the health care system. It shows how the performance of Medicare gave federal officials the resources to enforce racial ...
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This chapter explains how the radical politics of the South were enacted within the health care system. It shows how the performance of Medicare gave federal officials the resources to enforce racial integration on southern hospitals. The chapter notes that racial discrimination was widespread in the health care system, and that the legal basis for racial segregation was derived from the Plessy v. Ferguson case. It introduces the Hill-Burton, which was aimed at rural and poor communities that did not have access to health care, discusses the civil rights challenge, and also shows how Medicare was implemented.Less
This chapter explains how the radical politics of the South were enacted within the health care system. It shows how the performance of Medicare gave federal officials the resources to enforce racial integration on southern hospitals. The chapter notes that racial discrimination was widespread in the health care system, and that the legal basis for racial segregation was derived from the Plessy v. Ferguson case. It introduces the Hill-Burton, which was aimed at rural and poor communities that did not have access to health care, discusses the civil rights challenge, and also shows how Medicare was implemented.
Martin Pfaff
- Published in print:
- 2009
- Published Online:
- October 2013
- ISBN:
- 9780300149838
- eISBN:
- 9780300155952
- Item type:
- chapter
- Publisher:
- Yale University Press
- DOI:
- 10.12987/yale/9780300149838.003.0004
- Subject:
- Political Science, Comparative Politics
This chapter examines heath care reform in Germany. It begins with a brief description of the German health care system and its operation—its political dynamics and its recent evolution. It then ...
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This chapter examines heath care reform in Germany. It begins with a brief description of the German health care system and its operation—its political dynamics and its recent evolution. It then turns to the role of evidence and learning in general and in the German context in particular, citing examples of evidence versus interests and power as guiding principles in the policy-making process and of cross-border learning for and from the German experience.Less
This chapter examines heath care reform in Germany. It begins with a brief description of the German health care system and its operation—its political dynamics and its recent evolution. It then turns to the role of evidence and learning in general and in the German context in particular, citing examples of evidence versus interests and power as guiding principles in the policy-making process and of cross-border learning for and from the German experience.
Julian Tudor Hart
- Published in print:
- 2010
- Published Online:
- March 2012
- ISBN:
- 9781847427830
- eISBN:
- 9781447303930
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781847427830.003.0002
- Subject:
- Public Health and Epidemiology, Public Health
Health is not the only sort of wealth which the NHS produces, but like all health care systems, whether for fees, profit or public service, this purports to be its principal product. For commercial ...
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Health is not the only sort of wealth which the NHS produces, but like all health care systems, whether for fees, profit or public service, this purports to be its principal product. For commercial health care, for professional or corporate trade, health gain is in fact a byproduct. It is necessarily subordinated to the profit required to justify the business of either entrepreneur professionals or corporate providers. Only through public service is it possible to set health gain as a planned social goal and a direct objective. As an independent gift economy, the pre-reform NHS had social authority and public trust. As a principal byproduct, it helped to provide a robust social framework both for the accumulation of wealth and for the development of new social customs and institutions for a future cooperative society, and new patterns of useful employment.Less
Health is not the only sort of wealth which the NHS produces, but like all health care systems, whether for fees, profit or public service, this purports to be its principal product. For commercial health care, for professional or corporate trade, health gain is in fact a byproduct. It is necessarily subordinated to the profit required to justify the business of either entrepreneur professionals or corporate providers. Only through public service is it possible to set health gain as a planned social goal and a direct objective. As an independent gift economy, the pre-reform NHS had social authority and public trust. As a principal byproduct, it helped to provide a robust social framework both for the accumulation of wealth and for the development of new social customs and institutions for a future cooperative society, and new patterns of useful employment.
