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/9780195160390.003.0008
- Subject:
- Sociology, Race and Ethnicity
This chapter demonstrates how the coalition of insurance companies, managed-care firms, and small businesses destroyed a proposal for home care for disabled people in the 1980s, and notes that the ...
More
This chapter demonstrates how the coalition of insurance companies, managed-care firms, and small businesses destroyed a proposal for home care for disabled people in the 1980s, and notes that the same coalition also attacked President Clinton's plan for universal health care in the 1990s. It begins by discussing long-term care for the weak elderly, then looks at another revival of the national health insurance and introduces the Consolidated Omnibus Reconciliation Act of 1985, which tried to fill the gaps within the private health insurance system. The chapter then studies health policy making after the Health Security failed.Less
This chapter demonstrates how the coalition of insurance companies, managed-care firms, and small businesses destroyed a proposal for home care for disabled people in the 1980s, and notes that the same coalition also attacked President Clinton's plan for universal health care in the 1990s. It begins by discussing long-term care for the weak elderly, then looks at another revival of the national health insurance and introduces the Consolidated Omnibus Reconciliation Act of 1985, which tried to fill the gaps within the private health insurance system. The chapter then studies health policy making after the Health Security failed.
Jennifer Prah Ruger
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199559978
- eISBN:
- 9780191721489
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199559978.003.0008
- Subject:
- Economics and Finance, Public and Welfare
This chapter provides an alternative moral framework for analyzing health financing. In the health capability paradigm, continuous universal health insurance is essential for human flourishing. Its ...
More
This chapter provides an alternative moral framework for analyzing health financing. In the health capability paradigm, continuous universal health insurance is essential for human flourishing. Its central ethical aims are to ensure individual health, develop health functioning and agency, and enhance security. Universal health insurance requires resource redistribution, regulation and public goods creation. In contrast to mainstream economic theory, behavioral economics and prospect theory, the health capability paradigm's view of health insurance focuses on individuals' exposure to risk and their ability to manage it adequately, rather than their preferences regarding it. Under this paradigm, universal health insurance is morally justified because it ensures human flourishing and protects against vulnerability and insecurity. Unlike existing theories in medical ethics, a distinction is made between the promotion of equal access to health care and equal access to the gains in well‐being that accrue from risk pooling and health insurance. The chapter concludes with empirical evidence on the equity of health financing models and examines the public sector's role in creating equitable and efficient health systems, providing public goods and buffering market failures.Less
This chapter provides an alternative moral framework for analyzing health financing. In the health capability paradigm, continuous universal health insurance is essential for human flourishing. Its central ethical aims are to ensure individual health, develop health functioning and agency, and enhance security. Universal health insurance requires resource redistribution, regulation and public goods creation. In contrast to mainstream economic theory, behavioral economics and prospect theory, the health capability paradigm's view of health insurance focuses on individuals' exposure to risk and their ability to manage it adequately, rather than their preferences regarding it. Under this paradigm, universal health insurance is morally justified because it ensures human flourishing and protects against vulnerability and insecurity. Unlike existing theories in medical ethics, a distinction is made between the promotion of equal access to health care and equal access to the gains in well‐being that accrue from risk pooling and health insurance. The chapter concludes with empirical evidence on the equity of health financing models and examines the public sector's role in creating equitable and efficient health systems, providing public goods and buffering market failures.
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 ...
More
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.
Eli Ginzberg
- Published in print:
- 2000
- Published Online:
- October 2013
- ISBN:
- 9780300082326
- eISBN:
- 9780300133011
- Item type:
- book
- Publisher:
- Yale University Press
- DOI:
- 10.12987/yale/9780300082326.001.0001
- Subject:
- Sociology, Social Stratification, Inequality, and Mobility
Academic health centers (AHCs) have played a key role in propelling the United States to world leadership in technological advances in medicine. At the same time, however, many of these urban-based ...
More
Academic health centers (AHCs) have played a key role in propelling the United States to world leadership in technological advances in medicine. At the same time, however, many of these urban-based hospitals have largely ignored the medical care of their poor neighbors. Now one of the leading experts in American health policy and economics ponders whether current and proposed changes in the financing and delivery of medical care will result in a realignment between AHCs and the poor. Basing the discussion on an analysis of the nation's twenty-five leading research-oriented health centers, this book traces the history of AHCs in the twentieth century. It claims that AHCs are once again moving toward treating the poor because these hospitals need to admit more Medicaid patients to fill their empty beds, and their medical students need opportunities to practice in ambulatory sites. It also assesses some of the more important trends that may challenge the AHCs, including financial concerns, changing medical practice environments, and the likelihood of some form of universal health insurance.Less
Academic health centers (AHCs) have played a key role in propelling the United States to world leadership in technological advances in medicine. At the same time, however, many of these urban-based hospitals have largely ignored the medical care of their poor neighbors. Now one of the leading experts in American health policy and economics ponders whether current and proposed changes in the financing and delivery of medical care will result in a realignment between AHCs and the poor. Basing the discussion on an analysis of the nation's twenty-five leading research-oriented health centers, this book traces the history of AHCs in the twentieth century. It claims that AHCs are once again moving toward treating the poor because these hospitals need to admit more Medicaid patients to fill their empty beds, and their medical students need opportunities to practice in ambulatory sites. It also assesses some of the more important trends that may challenge the AHCs, including financial concerns, changing medical practice environments, and the likelihood of some form of universal health insurance.
Joseph Harris
- Published in print:
- 2017
- Published Online:
- May 2018
- ISBN:
- 9781501709968
- eISBN:
- 9781501714832
- Item type:
- book
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9781501709968.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
Why do resource-constrained countries make costly commitments to universal health coverage and AIDS treatment after transitioning to democracy? At a time when the world’s wealthiest nations struggle ...
More
Why do resource-constrained countries make costly commitments to universal health coverage and AIDS treatment after transitioning to democracy? At a time when the world’s wealthiest nations struggle to make healthcare and medicine available to everyone, this book explores the dynamics that made landmark policies possible in Thailand and Brazil but which have led to prolonged struggle and contestation in South Africa. While conventional wisdom suggests that democratization empowers the masses, this book draws attention to an underappreciated dynamic: that democratization empowers elites from esteemed professions – frequently doctors and lawyers – who forge progressive change on behalf of those in need in the face of broader opposition at home and from abroad. The relative success of professional movements in Thailand and Brazil and failure in South Africa highlights critical differences in the character of political competition. Whereas fierce political competition provided opportunities for professional movements to have surprising influence on the policymaking process in Thailand and Brazil, the unrivaled dominance of the African National Congress allowed the ruling party the luxury of entertaining only limited healthcare reform and charlatan AIDS policy in South Africa. The book offers lessons for the United States and other countries seeking to embark on expansive health reforms.Less
Why do resource-constrained countries make costly commitments to universal health coverage and AIDS treatment after transitioning to democracy? At a time when the world’s wealthiest nations struggle to make healthcare and medicine available to everyone, this book explores the dynamics that made landmark policies possible in Thailand and Brazil but which have led to prolonged struggle and contestation in South Africa. While conventional wisdom suggests that democratization empowers the masses, this book draws attention to an underappreciated dynamic: that democratization empowers elites from esteemed professions – frequently doctors and lawyers – who forge progressive change on behalf of those in need in the face of broader opposition at home and from abroad. The relative success of professional movements in Thailand and Brazil and failure in South Africa highlights critical differences in the character of political competition. Whereas fierce political competition provided opportunities for professional movements to have surprising influence on the policymaking process in Thailand and Brazil, the unrivaled dominance of the African National Congress allowed the ruling party the luxury of entertaining only limited healthcare reform and charlatan AIDS policy in South Africa. The book offers lessons for the United States and other countries seeking to embark on expansive health reforms.
K. Srinath Reddy and Manu Raj Mathur
- Published in print:
- 2018
- Published Online:
- July 2019
- ISBN:
- 9780199482160
- eISBN:
- 9780199097746
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780199482160.003.0015
- Subject:
- Sociology, Health, Illness, and Medicine, Social Stratification, Inequality, and Mobility
In the last few decades, several initiatives have been undertaken by Government of India to increase access to essential health services. A framework for UHC was also developed by a High Level Expert ...
More
In the last few decades, several initiatives have been undertaken by Government of India to increase access to essential health services. A framework for UHC was also developed by a High Level Expert Group (HLEG). The recently developed National Health Policy of India also espouses equity, universality, and affordability among its key principles and commits higher financial resources with emphasis on Primary Health Care. For UHC to be viable, it has to be embedded in a broad based framework of health assurance, based on a conceptual model that extends from financial protection, across a well-functioning health system, to the social determinants of health.Less
In the last few decades, several initiatives have been undertaken by Government of India to increase access to essential health services. A framework for UHC was also developed by a High Level Expert Group (HLEG). The recently developed National Health Policy of India also espouses equity, universality, and affordability among its key principles and commits higher financial resources with emphasis on Primary Health Care. For UHC to be viable, it has to be embedded in a broad based framework of health assurance, based on a conceptual model that extends from financial protection, across a well-functioning health system, to the social determinants of health.
Alex Rajczi
- Published in print:
- 2019
- Published Online:
- June 2019
- ISBN:
- 9780190946838
- eISBN:
- 9780190946869
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190946838.003.0004
- Subject:
- Philosophy, Moral Philosophy
Some people object to social minimum programs, including certain health care programs, because they believe the programs impose excessive taxes and other personal costs on those who fund them. This ...
More
Some people object to social minimum programs, including certain health care programs, because they believe the programs impose excessive taxes and other personal costs on those who fund them. This chapter argues that the most plausible philosophical reconstruction of this objection would rely on a personal cost principle which says that, in general, the proper level of the social minimum is at least partly a function of whether the benefits provided by the social minimum programs outweigh the costs, when judged on a scale that assigns disproportionate weight to those who bear the costs. It is argued that the personal cost principle can find a place within several plausible theories of justice, and that, in addition, the benefits of a well-designed universal health insurance system outweigh its costs.Less
Some people object to social minimum programs, including certain health care programs, because they believe the programs impose excessive taxes and other personal costs on those who fund them. This chapter argues that the most plausible philosophical reconstruction of this objection would rely on a personal cost principle which says that, in general, the proper level of the social minimum is at least partly a function of whether the benefits provided by the social minimum programs outweigh the costs, when judged on a scale that assigns disproportionate weight to those who bear the costs. It is argued that the personal cost principle can find a place within several plausible theories of justice, and that, in addition, the benefits of a well-designed universal health insurance system outweigh its costs.
Alex Rajczi
- Published in print:
- 2019
- Published Online:
- June 2019
- ISBN:
- 9780190946838
- eISBN:
- 9780190946869
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190946838.003.0005
- Subject:
- Philosophy, Moral Philosophy
Some people express concern that social minimum programs might be ineffective, inefficient, counterproductive, or unnecessary. This chapter focuses on three specific worries about efficacy that are ...
More
Some people express concern that social minimum programs might be ineffective, inefficient, counterproductive, or unnecessary. This chapter focuses on three specific worries about efficacy that are often expressed in real-world debates about universal health insurance: the worries that universal health insurance systems would not improve aggregate national health, that they would reduce medical innovation, and that they would produce waiting lists. The first is best addressed using purely factual information, but concerns about innovation and wait lists require philosophical analysis. The chapter argues that concerns about innovation and wait lists are philosophically misguided.Less
Some people express concern that social minimum programs might be ineffective, inefficient, counterproductive, or unnecessary. This chapter focuses on three specific worries about efficacy that are often expressed in real-world debates about universal health insurance: the worries that universal health insurance systems would not improve aggregate national health, that they would reduce medical innovation, and that they would produce waiting lists. The first is best addressed using purely factual information, but concerns about innovation and wait lists require philosophical analysis. The chapter argues that concerns about innovation and wait lists are philosophically misguided.
Jan Abel Olsen
- Published in print:
- 2017
- Published Online:
- September 2017
- ISBN:
- 9780198794837
- eISBN:
- 9780191836329
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780198794837.003.0011
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter considers two different ways of organizing revenue collection in statutory healthcare schemes: social health insurance and taxation. The two models are commonly referred to as ‘Bismarck ...
More
This chapter considers two different ways of organizing revenue collection in statutory healthcare schemes: social health insurance and taxation. The two models are commonly referred to as ‘Bismarck vs Beveridge’ after the men associated with the origin of these systems: the first German chancellor Otto von Bismarck (1815–1898), and the British economist Lord William Beveridge (1879–1963). The differences between these two compulsory prepayment schemes are discussed and compared with private health insurance. Based on a simple diagram introduced by the World Health Organization, three dimensions of coverage are illustrated. Some policy dilemmas are highlighted when attempting to achieve universal health coverage. Finally, various combinations of public and private prepayment schemes are discussed.Less
This chapter considers two different ways of organizing revenue collection in statutory healthcare schemes: social health insurance and taxation. The two models are commonly referred to as ‘Bismarck vs Beveridge’ after the men associated with the origin of these systems: the first German chancellor Otto von Bismarck (1815–1898), and the British economist Lord William Beveridge (1879–1963). The differences between these two compulsory prepayment schemes are discussed and compared with private health insurance. Based on a simple diagram introduced by the World Health Organization, three dimensions of coverage are illustrated. Some policy dilemmas are highlighted when attempting to achieve universal health coverage. Finally, various combinations of public and private prepayment schemes are discussed.
Ronald Labonté and Arne Ruckert
- Published in print:
- 2019
- Published Online:
- May 2019
- ISBN:
- 9780198835356
- eISBN:
- 9780191872952
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780198835356.003.0008
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Strengthening health systems in poorer countries has long been a focal point in development aid debates. Visionary models of comprehensive primary health care caught the global imagination in the ...
More
Strengthening health systems in poorer countries has long been a focal point in development aid debates. Visionary models of comprehensive primary health care caught the global imagination in the late 1970s but were quickly eclipsed with the rise of neoliberal globalization in the 1980s, truncated into ‘selective’ silos appealing to donor nations. ‘Investing in health’ for economic growth eclipsed more humanitarian principles for health assistance. Corporate philanthropies began to set health agendas resonant with those of a century earlier, while private health care financing and delivery models that grew under neoliberalism’s first wave (structural adjustment) have yet to yield to the evidence of the efficiencies of public health care models. The current push to achieve Universal Health Coverage captures the ongoing tension between the interests of private capital and the need for public goods.Less
Strengthening health systems in poorer countries has long been a focal point in development aid debates. Visionary models of comprehensive primary health care caught the global imagination in the late 1970s but were quickly eclipsed with the rise of neoliberal globalization in the 1980s, truncated into ‘selective’ silos appealing to donor nations. ‘Investing in health’ for economic growth eclipsed more humanitarian principles for health assistance. Corporate philanthropies began to set health agendas resonant with those of a century earlier, while private health care financing and delivery models that grew under neoliberalism’s first wave (structural adjustment) have yet to yield to the evidence of the efficiencies of public health care models. The current push to achieve Universal Health Coverage captures the ongoing tension between the interests of private capital and the need for public goods.
Armando De Negri Filho
- Published in print:
- 2013
- Published Online:
- September 2013
- ISBN:
- 9780199661619
- eISBN:
- 9780191765056
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199661619.003.0012
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter documents recent legal and political developments regarding the constitutional right to health in Brazil, where a broad social acceptance of this right continues to propel movement ...
More
This chapter documents recent legal and political developments regarding the constitutional right to health in Brazil, where a broad social acceptance of this right continues to propel movement towards an equitable universal health system. It begins with a history of Brazil and an overview of the nation’s health. It then discusses human rights and accountability in Brazil; the availability, accessibility, acceptability, and quality of healthcare; limitations on rights under domestic laws to protect public health; the history of failures with respect to the human right to health; and future national directions towards the right to health.Less
This chapter documents recent legal and political developments regarding the constitutional right to health in Brazil, where a broad social acceptance of this right continues to propel movement towards an equitable universal health system. It begins with a history of Brazil and an overview of the nation’s health. It then discusses human rights and accountability in Brazil; the availability, accessibility, acceptability, and quality of healthcare; limitations on rights under domestic laws to protect public health; the history of failures with respect to the human right to health; and future national directions towards the right to health.
Joia S. Mukherjee
- Published in print:
- 2017
- Published Online:
- December 2017
- ISBN:
- 9780190662455
- eISBN:
- 9780190662486
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190662455.003.0011
- Subject:
- Public Health and Epidemiology, Public Health
This chapter explores the seminal topic of Universal Health Coverage (UHC), an objective within the Sustainable Development goals. It reviews the theory and definitions that shape the current ...
More
This chapter explores the seminal topic of Universal Health Coverage (UHC), an objective within the Sustainable Development goals. It reviews the theory and definitions that shape the current conversation on UHC. The movement from selective primary health care to UHC demonstrates a global commitment to the progressive realization of the right to health. However, access to UHC is limited by barriers to care, inadequate provision of care, and poor-quality services. To deliver UHC, it is critical to align inputs in the health system with the burden of disease. Quality of care must also be improved. Steady, sufficient financing is needed to achieve the laudable goal of UHC.This chapter highlights some important steps taken by countries to expand access to quality health care. Finally, the chapter investigates the theory and practice behind a morbidity-based approach to strengthening health systems and achieving UHC.Less
This chapter explores the seminal topic of Universal Health Coverage (UHC), an objective within the Sustainable Development goals. It reviews the theory and definitions that shape the current conversation on UHC. The movement from selective primary health care to UHC demonstrates a global commitment to the progressive realization of the right to health. However, access to UHC is limited by barriers to care, inadequate provision of care, and poor-quality services. To deliver UHC, it is critical to align inputs in the health system with the burden of disease. Quality of care must also be improved. Steady, sufficient financing is needed to achieve the laudable goal of UHC.This chapter highlights some important steps taken by countries to expand access to quality health care. Finally, the chapter investigates the theory and practice behind a morbidity-based approach to strengthening health systems and achieving UHC.
Purendra Prasad and Amar Jesani (eds)
- Published in print:
- 2018
- Published Online:
- July 2019
- ISBN:
- 9780199482160
- eISBN:
- 9780199097746
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780199482160.001.0001
- Subject:
- Sociology, Health, Illness, and Medicine, Social Stratification, Inequality, and Mobility
Equity and Access attempts to unravel the complex narrative of why inequities in the health sector are growing and access to basic health care is worsening, and the underlying forces that contribute ...
More
Equity and Access attempts to unravel the complex narrative of why inequities in the health sector are growing and access to basic health care is worsening, and the underlying forces that contribute to this situation. It draws attention to the way globalization has influenced India’s development trajectory as health care issues have assumed significant socio-economic and political significance in contemporary India. The volume explains how state and market forces have progressively heightened the iniquitous health care system and the process through which substantial burden of meeting health care needs has fallen on the individual households. Twenty-eight scholars comprising social scientists, medical experts, public health experts, policy makers, health activists, legal experts, and gender specialists have delved into the politics of access for different classes, castes, gender, and other categories to contribute to a new field of ‘health care studies’ in this volume. Adopting an interdisciplinary approach within a broader political-economy framework, the volume is useful for understanding power relations within social groups and complex organizational systems.Less
Equity and Access attempts to unravel the complex narrative of why inequities in the health sector are growing and access to basic health care is worsening, and the underlying forces that contribute to this situation. It draws attention to the way globalization has influenced India’s development trajectory as health care issues have assumed significant socio-economic and political significance in contemporary India. The volume explains how state and market forces have progressively heightened the iniquitous health care system and the process through which substantial burden of meeting health care needs has fallen on the individual households. Twenty-eight scholars comprising social scientists, medical experts, public health experts, policy makers, health activists, legal experts, and gender specialists have delved into the politics of access for different classes, castes, gender, and other categories to contribute to a new field of ‘health care studies’ in this volume. Adopting an interdisciplinary approach within a broader political-economy framework, the volume is useful for understanding power relations within social groups and complex organizational systems.
Mugambi Jouet
- Published in print:
- 2017
- Published Online:
- September 2017
- ISBN:
- 9780520293298
- eISBN:
- 9780520966468
- Item type:
- chapter
- Publisher:
- University of California Press
- DOI:
- 10.1525/california/9780520293298.003.0006
- Subject:
- Political Science, American Politics
Wealth inequality is much sharper in America than all other industrialized countries. The income of the richest 1% Americans has soared while the income of ordinary people either decreased or ...
More
Wealth inequality is much sharper in America than all other industrialized countries. The income of the richest 1% Americans has soared while the income of ordinary people either decreased or stagnated in recent decades. However, America used to be a rather middle-class society. It was not before the 1980s that the G.O.P.’s far-right branch grew more influential in challenging the oppression of “big government.” New Deal era policies were gradually abandoned and wealth inequality soared. Ronald Reagan claimed that “fascism was really the basis for the New Deal,” and his heirs followed suit in denouncing the federal government’s “tyranny.”
Overall, the center of the U.S. political debate on economic issues is drastically more to the right than in Europe, Canada, Australia, and New Zealand. The Democratic Party is far less devoted to the interests of the poor, the working-class, and the middle-class than other left-wing parties in the West. The G.O.P. tends to cater only to the richest of the rich, unlike virtually no other major conservative party in the modern Western world.Less
Wealth inequality is much sharper in America than all other industrialized countries. The income of the richest 1% Americans has soared while the income of ordinary people either decreased or stagnated in recent decades. However, America used to be a rather middle-class society. It was not before the 1980s that the G.O.P.’s far-right branch grew more influential in challenging the oppression of “big government.” New Deal era policies were gradually abandoned and wealth inequality soared. Ronald Reagan claimed that “fascism was really the basis for the New Deal,” and his heirs followed suit in denouncing the federal government’s “tyranny.”
Overall, the center of the U.S. political debate on economic issues is drastically more to the right than in Europe, Canada, Australia, and New Zealand. The Democratic Party is far less devoted to the interests of the poor, the working-class, and the middle-class than other left-wing parties in the West. The G.O.P. tends to cater only to the richest of the rich, unlike virtually no other major conservative party in the modern Western world.
Sunil Nandraj and Devaki Nambiar
- Published in print:
- 2018
- Published Online:
- July 2019
- ISBN:
- 9780199482160
- eISBN:
- 9780199097746
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780199482160.003.0016
- Subject:
- Sociology, Health, Illness, and Medicine, Social Stratification, Inequality, and Mobility
Despite a strong legacy of human development, the state of Kerala faces challenges of shifting epidemiologic burden and privatization driven cost escalation. Mindful of this, the Government of Kerala ...
More
Despite a strong legacy of human development, the state of Kerala faces challenges of shifting epidemiologic burden and privatization driven cost escalation. Mindful of this, the Government of Kerala initiated a pilot study on Universal Health Coverage reforms in two districts. An assessment was carried out, drawing data from about 60 sources, revealing critical information about overcrowding and understaffing at block level facilities, critical gaps in health human resources, the top 20 conditions and events for which care is sought—where non-communicable conditions dominate. On the basis of this, it was proposed that comprehensive care pathways be created—Kerala’s version of an Essential Health Package, delivered through a re-engineered health system.Less
Despite a strong legacy of human development, the state of Kerala faces challenges of shifting epidemiologic burden and privatization driven cost escalation. Mindful of this, the Government of Kerala initiated a pilot study on Universal Health Coverage reforms in two districts. An assessment was carried out, drawing data from about 60 sources, revealing critical information about overcrowding and understaffing at block level facilities, critical gaps in health human resources, the top 20 conditions and events for which care is sought—where non-communicable conditions dominate. On the basis of this, it was proposed that comprehensive care pathways be created—Kerala’s version of an Essential Health Package, delivered through a re-engineered health system.
Alex Rajczi
- Published in print:
- 2019
- Published Online:
- June 2019
- ISBN:
- 9780190946838
- eISBN:
- 9780190946869
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190946838.003.0002
- Subject:
- Philosophy, Moral Philosophy
One cannot discuss the ethics of health policy without understanding how health systems work, so this chapter provides background on the American health system before and after the Affordable Care ...
More
One cannot discuss the ethics of health policy without understanding how health systems work, so this chapter provides background on the American health system before and after the Affordable Care Act. It also describes two universal health insurance systems the U.S. could adopt. In Canada’s single-payer system, the government serves as the basic insurer for the entire population. In the regulated-market systems of Switzerland and the Netherlands, citizens must purchase health insurance through private companies, and the government’s main jobs are providing subsidies to less wealthy individuals and ensuring that insurance companies deal fairly with citizens. The chapter concludes by examining the core ideas behind consumer-driven health care, a set of specific policies that conservatives often add to their health care proposals.Less
One cannot discuss the ethics of health policy without understanding how health systems work, so this chapter provides background on the American health system before and after the Affordable Care Act. It also describes two universal health insurance systems the U.S. could adopt. In Canada’s single-payer system, the government serves as the basic insurer for the entire population. In the regulated-market systems of Switzerland and the Netherlands, citizens must purchase health insurance through private companies, and the government’s main jobs are providing subsidies to less wealthy individuals and ensuring that insurance companies deal fairly with citizens. The chapter concludes by examining the core ideas behind consumer-driven health care, a set of specific policies that conservatives often add to their health care proposals.
Fran Baum
- Published in print:
- 2019
- Published Online:
- January 2019
- ISBN:
- 9780190258948
- eISBN:
- 9780190258979
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190258948.003.0004
- Subject:
- Public Health and Epidemiology, Public Health
Many assume that the health sector is the central government agency for health. Yet very often, health sectors are actually “illness care” sectors that give little concern to the production or ...
More
Many assume that the health sector is the central government agency for health. Yet very often, health sectors are actually “illness care” sectors that give little concern to the production or maintenance of health. This chapter argues that this state of affairs needs to change so that health sectors do become stewards of the health of the population they are established to serve. Achieving such a health sector will require strong and determined leadership that is able to ensure that curative functions are effective, while also ensuring that disease prevention and health promotion flourish. This is vital to governing for health. This chapter examines the importance of primary health care, disease prevention, and health promotion. The chapter plays particular attention to community strategies, including community ownership of health services, and public health functions, including health impact assessments and Health in All Policies.Less
Many assume that the health sector is the central government agency for health. Yet very often, health sectors are actually “illness care” sectors that give little concern to the production or maintenance of health. This chapter argues that this state of affairs needs to change so that health sectors do become stewards of the health of the population they are established to serve. Achieving such a health sector will require strong and determined leadership that is able to ensure that curative functions are effective, while also ensuring that disease prevention and health promotion flourish. This is vital to governing for health. This chapter examines the importance of primary health care, disease prevention, and health promotion. The chapter plays particular attention to community strategies, including community ownership of health services, and public health functions, including health impact assessments and Health in All Policies.
Alex Rajczi
- Published in print:
- 2019
- Published Online:
- June 2019
- ISBN:
- 9780190946838
- eISBN:
- 9780190946869
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190946838.003.0001
- Subject:
- Philosophy, Moral Philosophy
Most Americans see the need for a national health policy that guarantees reasonable access to health insurance for all citizens, but some worry that a universal health insurance system would be ...
More
Most Americans see the need for a national health policy that guarantees reasonable access to health insurance for all citizens, but some worry that a universal health insurance system would be inefficient, create excessive fiscal risk, or demand too much of them, either by increasing their taxes or by rendering their own health insurance unaffordable. After describing these three objections and the role they play in health care debates, the introduction outlines the contents of each chapter. It concludes with some remarks about how data will be handled in the book’s later chapters.Less
Most Americans see the need for a national health policy that guarantees reasonable access to health insurance for all citizens, but some worry that a universal health insurance system would be inefficient, create excessive fiscal risk, or demand too much of them, either by increasing their taxes or by rendering their own health insurance unaffordable. After describing these three objections and the role they play in health care debates, the introduction outlines the contents of each chapter. It concludes with some remarks about how data will be handled in the book’s later chapters.
Daniel D. Reidpath and Pascale Allotey
- Published in print:
- 2019
- Published Online:
- July 2019
- ISBN:
- 9780198814733
- eISBN:
- 9780191852459
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780198814733.003.0003
- Subject:
- Public Health and Epidemiology, Public Health
In this chapter, the authors outline the layers of disadvantage that exist for refugees within the context of national policies that restrict their access to services, including health care and ...
More
In this chapter, the authors outline the layers of disadvantage that exist for refugees within the context of national policies that restrict their access to services, including health care and social services, in countries where they hope to seek refuge, despite the existence of long-standing international conventions on the rights of refugees and other displaced persons. The chapter explores theories that entrench othering and social exclusion of these populations. The authors also outline the potential entry points to addressing the health of refugees and other migrants as a result of recent initiatives offered through the Sustainable Development Agenda and universal health coverage.Less
In this chapter, the authors outline the layers of disadvantage that exist for refugees within the context of national policies that restrict their access to services, including health care and social services, in countries where they hope to seek refuge, despite the existence of long-standing international conventions on the rights of refugees and other displaced persons. The chapter explores theories that entrench othering and social exclusion of these populations. The authors also outline the potential entry points to addressing the health of refugees and other migrants as a result of recent initiatives offered through the Sustainable Development Agenda and universal health coverage.
Alex Rajczi
- Published in print:
- 2019
- Published Online:
- June 2019
- ISBN:
- 9780190946838
- eISBN:
- 9780190946869
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190946838.001.0001
- Subject:
- Philosophy, Moral Philosophy
Millions of Americans lack health insurance, and thousands suffer and die every year. Philosophers have argued that an ideal society would avoid these problems by guaranteeing affordable access to ...
More
Millions of Americans lack health insurance, and thousands suffer and die every year. Philosophers have argued that an ideal society would avoid these problems by guaranteeing affordable access to health insurance, but what about people’s concerns that a universal health insurance system would be inefficient, create excessive fiscal risk, or impose high taxes and other personal costs? This book examines the ethical issues raised by these objections. It shows that the ethical principles underlying these concerns are legitimate and that they might even justify opposition to poorly designed universal health insurance plans. However, the objections do not undercut the moral case for adopting a well-designed universal health insurance system that improves on the gains made in the Affordable Care Act. Addressing these objections is important because they are philosophically rich and interesting, and since the objections help drive actual disagreements about health policy, responding to them also contributes to the real-world case for universal access to health insurance. Understanding these issues in the health care debate has larger upshots as well. It leads us to a deeper understanding of progressive and conservative views on distributive justice, and it provides a framework for analyzing debates about any part of the social safety net—in America and elsewhere.Less
Millions of Americans lack health insurance, and thousands suffer and die every year. Philosophers have argued that an ideal society would avoid these problems by guaranteeing affordable access to health insurance, but what about people’s concerns that a universal health insurance system would be inefficient, create excessive fiscal risk, or impose high taxes and other personal costs? This book examines the ethical issues raised by these objections. It shows that the ethical principles underlying these concerns are legitimate and that they might even justify opposition to poorly designed universal health insurance plans. However, the objections do not undercut the moral case for adopting a well-designed universal health insurance system that improves on the gains made in the Affordable Care Act. Addressing these objections is important because they are philosophically rich and interesting, and since the objections help drive actual disagreements about health policy, responding to them also contributes to the real-world case for universal access to health insurance. Understanding these issues in the health care debate has larger upshots as well. It leads us to a deeper understanding of progressive and conservative views on distributive justice, and it provides a framework for analyzing debates about any part of the social safety net—in America and elsewhere.
