Jessica M. Mulligan
- Published in print:
- 2014
- Published Online:
- March 2016
- ISBN:
- 9780814724910
- eISBN:
- 9780814764992
- Item type:
- chapter
- Publisher:
- NYU Press
- DOI:
- 10.18574/nyu/9780814724910.003.0001
- Subject:
- Anthropology, Medical Anthropology
This introductory chapter explores the changes made to the national health care system of Puerto Rico as a result of the passing of the Medicare Modernization Act (MMA) in 2003—a legislation that ...
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This introductory chapter explores the changes made to the national health care system of Puerto Rico as a result of the passing of the Medicare Modernization Act (MMA) in 2003—a legislation that extended the role of private contractors in the federal Medicare program. Specifically, the Act vastly expanded the managed care program in Medicare by changing its funding structure, adding additional managed care plan types, and creating prescription-drug coverage that would be administered by private companies. The chapter also examines the series of market-based—or neoliberal—reforms made in 1990s, which privatized the regional health system by closing public health facilities and by enrolling eligible beneficiaries in private managed care health plans. Because of this, privatization intensified due to market-based reforms in the Medicare program. Together, these two waves of privatization radically remade the health system on the island as Puerto Rican citizens became consumers of private insurance coverage.Less
This introductory chapter explores the changes made to the national health care system of Puerto Rico as a result of the passing of the Medicare Modernization Act (MMA) in 2003—a legislation that extended the role of private contractors in the federal Medicare program. Specifically, the Act vastly expanded the managed care program in Medicare by changing its funding structure, adding additional managed care plan types, and creating prescription-drug coverage that would be administered by private companies. The chapter also examines the series of market-based—or neoliberal—reforms made in 1990s, which privatized the regional health system by closing public health facilities and by enrolling eligible beneficiaries in private managed care health plans. Because of this, privatization intensified due to market-based reforms in the Medicare program. Together, these two waves of privatization radically remade the health system on the island as Puerto Rican citizens became consumers of private insurance coverage.
Neumann Peter J., Cohen Joshua T., and Ollendorf Daniel A
- Published in print:
- 2021
- Published Online:
- May 2021
- ISBN:
- 9780197512883
- eISBN:
- 9780197512913
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780197512883.003.0005
- Subject:
- Public Health and Epidemiology, Epidemiology, Public Health
As healthcare costs increased around the world in recent decades, countries incorporated health technology assessment (HTA) into their decisions about which new technologies to pay for and how much ...
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As healthcare costs increased around the world in recent decades, countries incorporated health technology assessment (HTA) into their decisions about which new technologies to pay for and how much they should pay. This chapter describes approaches for drug value assessment that are part of the HTA procedures in these countries, highlighting England and Wales’ National Institute for Health and Care Excellence, perhaps the world’s most visible HTA body. We then describe efforts since the 1980s to introduce HTA in the United States, including Oregon’s Medicaid experiment and the federally funded Office of Technology Assessment. The chapter explores the roots of resistance to these efforts, including the notion of American exceptionalism—the belief that personal and economic freedom is paramount and deep resistance to the idea of healthcare rationing. The resistance, explained at least partly by these factors, ultimately led to a scaling back of HTA in the United States.Less
As healthcare costs increased around the world in recent decades, countries incorporated health technology assessment (HTA) into their decisions about which new technologies to pay for and how much they should pay. This chapter describes approaches for drug value assessment that are part of the HTA procedures in these countries, highlighting England and Wales’ National Institute for Health and Care Excellence, perhaps the world’s most visible HTA body. We then describe efforts since the 1980s to introduce HTA in the United States, including Oregon’s Medicaid experiment and the federally funded Office of Technology Assessment. The chapter explores the roots of resistance to these efforts, including the notion of American exceptionalism—the belief that personal and economic freedom is paramount and deep resistance to the idea of healthcare rationing. The resistance, explained at least partly by these factors, ultimately led to a scaling back of HTA in the United States.
José Luis Velasco
- Published in print:
- 2012
- Published Online:
- September 2016
- ISBN:
- 9780520273535
- eISBN:
- 9780520954069
- Item type:
- chapter
- Publisher:
- University of California Press
- DOI:
- 10.1525/california/9780520273535.003.0007
- Subject:
- Sociology, Social Theory
This chapter examines Mexican institutions. These include the civil aviation authority, the public mail service, the national health care system, the tax authority, and the stock exchange. The first ...
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This chapter examines Mexican institutions. These include the civil aviation authority, the public mail service, the national health care system, the tax authority, and the stock exchange. The first four institutions are part of the federal government. This entails a limitation of their representativeness, for federal institutions tend to be more developed than their subnational counterparts. Yet each of the selected institutions is either the only one in its field or it is the largest and most developed. Therefore, one may say that they are representative of the best institutions that Mexico has in the respective sectors. Something similar can be said about the single private institution, the stock exchange. In sum, these five cases, although not good representatives of the diversity of Mexican institutions, are at the forefront of the country's developmental efforts.Less
This chapter examines Mexican institutions. These include the civil aviation authority, the public mail service, the national health care system, the tax authority, and the stock exchange. The first four institutions are part of the federal government. This entails a limitation of their representativeness, for federal institutions tend to be more developed than their subnational counterparts. Yet each of the selected institutions is either the only one in its field or it is the largest and most developed. Therefore, one may say that they are representative of the best institutions that Mexico has in the respective sectors. Something similar can be said about the single private institution, the stock exchange. In sum, these five cases, although not good representatives of the diversity of Mexican institutions, are at the forefront of the country's developmental efforts.
Valeria Fargion and Marco Mayer
- Published in print:
- 2015
- Published Online:
- November 2015
- ISBN:
- 9780198743996
- eISBN:
- 9780191803994
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198743996.003.0006
- Subject:
- Political Science, International Relations and Politics
The chapter deals with the EU as a global social policy actor. In detail, the first part shows how—starting with the Prodi Commission and until 2005–07—the EU paid increasing attention to the social ...
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The chapter deals with the EU as a global social policy actor. In detail, the first part shows how—starting with the Prodi Commission and until 2005–07—the EU paid increasing attention to the social dimension of globalization, by fully endorsing the MDG programme and stepping up its aid budget. The second part tests the EU’s impact on social policies at national levels by focusing on sub-Saharan countries—notably among the poorest and most deprived areas of the planet. The analysis shows a clear disconnect between EU’s official commitments and the policies implemented on the ground. Specific suggestions are then put forward on how to realign discourse and policy practice. The chapter argues that strengthening national health care systems, especially in the Least Developed Countries (LDCs), is a win-win strategy for the EU, but in the current political and economic context this appears an unlikely prospect.Less
The chapter deals with the EU as a global social policy actor. In detail, the first part shows how—starting with the Prodi Commission and until 2005–07—the EU paid increasing attention to the social dimension of globalization, by fully endorsing the MDG programme and stepping up its aid budget. The second part tests the EU’s impact on social policies at national levels by focusing on sub-Saharan countries—notably among the poorest and most deprived areas of the planet. The analysis shows a clear disconnect between EU’s official commitments and the policies implemented on the ground. Specific suggestions are then put forward on how to realign discourse and policy practice. The chapter argues that strengthening national health care systems, especially in the Least Developed Countries (LDCs), is a win-win strategy for the EU, but in the current political and economic context this appears an unlikely prospect.
George J. Annas
- Published in print:
- 2010
- Published Online:
- May 2015
- ISBN:
- 9780195391732
- eISBN:
- 9780190267650
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:osobl/9780195391732.001.0001
- Subject:
- Philosophy, Moral Philosophy
This book explores the current debates on global medical issues including national health care, experimental cancer drugs, quality of medicine and patient safety, preparation for a global flu ...
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This book explores the current debates on global medical issues including national health care, experimental cancer drugs, quality of medicine and patient safety, preparation for a global flu pandemic, and regulating/outlawing cloning and germline genetic alterations. The book addresses national security issues concerning current national policies such as the best response to bioterrorism, force-feeding hunger strikers at Guantanamo, killing civilians in Afghanistan, with an emphasis on the roles played by physicians and lawyers in each.Less
This book explores the current debates on global medical issues including national health care, experimental cancer drugs, quality of medicine and patient safety, preparation for a global flu pandemic, and regulating/outlawing cloning and germline genetic alterations. The book addresses national security issues concerning current national policies such as the best response to bioterrorism, force-feeding hunger strikers at Guantanamo, killing civilians in Afghanistan, with an emphasis on the roles played by physicians and lawyers in each.
Isser Woloch
- Published in print:
- 2019
- Published Online:
- September 2019
- ISBN:
- 9780300124354
- eISBN:
- 9780300242683
- Item type:
- book
- Publisher:
- Yale University Press
- DOI:
- 10.12987/yale/9780300124354.001.0001
- Subject:
- History, American History: 20th Century
Toward the end of World War II, the three democracies faced a common choice: return to the civic order of prewar normalcy or embark instead on a path of progressive transformation. This book assesses ...
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Toward the end of World War II, the three democracies faced a common choice: return to the civic order of prewar normalcy or embark instead on a path of progressive transformation. This book assesses the progressive agendas that crystallized in each of the allied democracies: their roots in the interwar decades, their development during wartime, the struggles to enact them in the early postwar years, and the mixed outcomes in each country. The book examines three progressive postwar manifestos that reveal a common agenda in the three nations. The issues at stake included priorities for reconstruction or reconversion; “full employment” via economic planning; price controls; the roles of trade unions; expansion of social security; national health care; public housing; and educational reform. The book persuasively adds the United States to a discussion that is usually focused solely on Europe.Less
Toward the end of World War II, the three democracies faced a common choice: return to the civic order of prewar normalcy or embark instead on a path of progressive transformation. This book assesses the progressive agendas that crystallized in each of the allied democracies: their roots in the interwar decades, their development during wartime, the struggles to enact them in the early postwar years, and the mixed outcomes in each country. The book examines three progressive postwar manifestos that reveal a common agenda in the three nations. The issues at stake included priorities for reconstruction or reconversion; “full employment” via economic planning; price controls; the roles of trade unions; expansion of social security; national health care; public housing; and educational reform. The book persuasively adds the United States to a discussion that is usually focused solely on Europe.
Atul Kalhan (ed.)
- Published in print:
- 2022
- Published Online:
- March 2022
- ISBN:
- 9780198864615
- eISBN:
- 9780191955167
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780198864615.003.0006
- Subject:
- Clinical Medicine and Allied Health, Endocrinology and Diabetes
This chapter covers core curriculum topics related to diabetes and lipid metabolism. The diagnosis, investigation, classification, and pathophysiology of Type 1 and Type 2 diabetes mellitus is ...
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This chapter covers core curriculum topics related to diabetes and lipid metabolism. The diagnosis, investigation, classification, and pathophysiology of Type 1 and Type 2 diabetes mellitus is discussed in detail. A table has been used to sum up the clinical characteristics of monogenic diabetes subtypes in a concise though comprehensive manner. The MCQs have been updated to reflect current clinical practice guidelines of the National Institute for Health and Care Excellence and Joint British Diabetes Societies. MCQs have been added which evaluate a trainee’s knowledge on the management of diabetes in special circumstances (e.g. pregnancy, elderly age group, adolescence) and on the use of technology (e.g. continuous glucose monitoring). The positioning of novel therapeutic agents such as glucagon-like peptide 1 receptor agonist and sodium-glucose cotransporter-2 inhibitor in the management of Type 2 diabetes mellius has been updated based on the current evidence base. This chapter includes questions on the diagnosis and management of diabetic emergencies such as diabetic ketoacidosis and hyperosmolar hyperglycaemic syndrome. MCQs have been added and updated to cover current guidelines for the management of dyslipidaemia.Less
This chapter covers core curriculum topics related to diabetes and lipid metabolism. The diagnosis, investigation, classification, and pathophysiology of Type 1 and Type 2 diabetes mellitus is discussed in detail. A table has been used to sum up the clinical characteristics of monogenic diabetes subtypes in a concise though comprehensive manner. The MCQs have been updated to reflect current clinical practice guidelines of the National Institute for Health and Care Excellence and Joint British Diabetes Societies. MCQs have been added which evaluate a trainee’s knowledge on the management of diabetes in special circumstances (e.g. pregnancy, elderly age group, adolescence) and on the use of technology (e.g. continuous glucose monitoring). The positioning of novel therapeutic agents such as glucagon-like peptide 1 receptor agonist and sodium-glucose cotransporter-2 inhibitor in the management of Type 2 diabetes mellius has been updated based on the current evidence base. This chapter includes questions on the diagnosis and management of diabetic emergencies such as diabetic ketoacidosis and hyperosmolar hyperglycaemic syndrome. MCQs have been added and updated to cover current guidelines for the management of dyslipidaemia.
