Tuesday, November 3, 2009

[EQ] Nordic health care systems - Recent reforms and current policy challenges

Nordic health care systems. Recent reforms and current policy challenges

 

Is there a Nordic approach to health care?

Jon Magnussen, Professor in the Department of Public Health and General Practice at the Norwegian University of Science and Technology in Trondheim, Norway.
Karsten Vrangb, Director of Research, Danish Institute of Governmental Research, Copenhagen, Denmark.
Richard B. Saltman, Associate Head of Research Policy at the European Observatory on Health Systems and Policies, and Professor of Health Policy and Management in the Rollins School of Public Health of Emory University in Atlanta, Georgia, USA.
Published by Open University Press - European Observatory on Health Systems and Policies Series  2009

Observatory Website: http://www.euro.who.int/observatory/Studies/20091021_2

 

Website: http://www.mcgraw-hill.co.uk/html/0335238130.html

 

Chapter 1: http://www.mcgraw-hill.co.uk/openup/chapters/9780335238132.pdf


“…..While this model has been long considered as one of the cornerstones of the Nordic social welfare state, praised for its consistent pursuit of universalism and equity through close coordination between different levels of public administration, more recently it has also been criticised for not allowing citizens to take a more active role in their healthcare, limiting patients’ choice as well as rationing uptake of healthcare services in various implicit ways, such as slow implementation of new technologies.

This study demystifies and challenges this idea of a monolithic model. While it is true that the health systems in Finland, Sweden, Denmark, and Norway have important common features, such as tax-based funding, universal access, a high level of decentralisation, and publicly owned and operated hospitals, the editors conclude that the reality is – or at least has become - considerably more complex. Especially since the early 1990s, healthcare systems in the four European Nordic countries have undergone a process of gradual change. Where they have mainly kept the goals and aspirations for their health system, each one of them has chosen their own path of reform, with different timing and approach.

The centrally initiated ‘big bang’ hospital reform of Norway and Denmark, for instance, contrasts markedly with the more pragmatic and voluntary changes underway in Sweden and Finland. The different Nordic countries have shown considerable variation at the structural level in the way that institutions are designed but also, at the policy level, substantial differences in the way strategies are conceived and implemented.

One notable area of change in the Nordic region has been in the provision of health care services, where principles of state monopoly and local political control have been questioned in terms of their ability to achieve the key goal of equity, both socially and geographically. As a result, different innovative forms of “new public management” (NPM) approaches have been introduced to managing healthcare delivery.

It is this pragmatic approach to adapting the health system to new developments and expectations while maintaining focus on the basic values and goals, that makes the Nordic systems both interesting and relevant, not only for policy makers in these countries but also more widely for health systems elsewhere in Europe and the world. ….”

            Content:

Part I Nordic health care systems: balancing stability and change
1 Introduction: the Nordic model of health care
2 Healthcare reform: the Nordic experience
3 The political process of restructuring Nordic health systems
4 Looking forward: future policy issues
Part II Nordic health systems: key issues
5 The changing political governance structures of Nordic health care systems
6 Meeting rising public expectations. the changing roles of patients and citizens
7 The changing autonomy of medical professions
8 Maintaining fiscal sustainability in the Nordic countries
9 Harnessing diversity of provision
10 Changing perceptions of equity and fairness
11 Reforming primary health care
12 Addressing the dual goals of improving health and reducing health inequalities
13 Changing demands for institutional management
14 The European Union: single market pressures
15 The Iceland healthcare system

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] Global Health in Times of Violence

Global Health in Times of Violence

Explores human rights and social justice through the intersection of global health and violence

Co-edited by Paul Farmer, Linda Whiteford, and Barbara Rylko-Bauer
Published by SAR (School for Advanced Research) Press. 2009

Website: www.globalhealth.sarweb.org

 

PDF [14p.] Prologue Coming to Terms with Global Violence and Health:
https://www12.ssldomain.com/schoolofamericanresearch/sarpress/images/pdf/sarpress_122.pdf



‘….What are the prospects for human health in a world threatened by disease and violence? Since World War II, at least 160 wars have erupted around the globe. Over 24 million people have died in these conflicts, and millions more suffered illness and injury. In this volume, leading scholars and practitioners examine the impact of structural, military, and communal violence on health, psychosocial well-being, and health care delivery.

 

By investigating the fields of violence that define our modern world, the authors are able to provide alternative global health paradigms that can be used to develop more effective policies and programs….”

Table of Contents from Global Health in Times of Violence

 

1. Prologue: Coming to Terms with Global Violence and Health -   Barbara Rylko-Bauer, Linda Whiteford, and Paul Farmer

2. Recognizing Invisible Violence: A Thirty-Year Ethnographic Retrospective -   Philippe Bourgois

3. “Landmine Boy” and the Tomorrow of Violence -  Paul Farmer

4. Fault Lines  - Carolyn Nordstrom

5. Failure to Protect, Failure to Provide: Refugee Reproductive Rights -   Linda Whiteford

6. A Violence of History: Accounting for AIDS in Post-apartheid South Africa  - Didier Fassin

7. Desperate Measures: A Syndemic Approach to the Anthropology of Health in a Violent City  - Merrill Singer

8. The Vicissitudes of Structural Violence: Nicaragua at the Turn of the Twenty-first Century  - James Quesada

9. Planting “Seeds of Health” in the Fields of Structural Violence: The Life and Death of Francisco Curruchiche -  H. K. Heggenhougen

10. Medicine in the Political Economy of Brutality: Reflections from the Holocaust and Beyond -  Barbara Rylko-Bauer

11. Epilogue: Global Health in Times of Violence—Finding Hope -  Linda Whiteford, Barbara Rylko-Bauer, and Paul Farmer

 

 

*      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
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    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.  

[EQ] The recent decline of inequality in Latin America: Argentina, Brazil, Mexico and Peru

The recent decline of inequality in Latin America: Argentina, Brazil, Mexico and Peru

Luis F. Lopez-Calva, UNDP Regional Bureau for Latin America

Nora Lustig, Tulane University and Center for Global Development

ECINEQ WP 2009 – 140

The Society for the Study of Economic Inequality (ECINEQ) – October 2009

 

Available online as PDF file [44p.] at: http://www.ecineq.org/milano/WP/ECINEQ2009-140.pdf

 

“……..Between 2000 and 2006, the Gini coefficient declined in 12 of the 17 Latin American countries for which data are available. Why has inequality declined? Have the changes in inequality been driven by market forces such as the demand and supply for labor with different skills? Or have governments become more redistributive than they used to be, and if so, why?

 

This paper attempts to answer these questions by focusing on the determinants of inequality in four countries: Argentina, Brazil, Mexico and Peru.

 

The analysis suggests that the decline in inequality is accounted for by two main factors:
(i) a fall in the earnings gap between skilled and low-skilled workers (through both quantity and price effects); and

(ii) more progressive government transfers (monetary and in-kind transfers). Demographic factors, such as a change in the proportion of adults (and working adults) per household, have been equalizing but the magnitude of their contribution has been small by comparison.

 

In Brazil, Mexico and Peru, the fall in earnings gap, in turn, is mainly the result of the expansion of basic education over the last couple of decades, which reduced inequality in attainment and made the returns to education curve less steep. It also results from the petering out of the unequalizing effect of skill-biased technical change in the 1990s associated with the opening up of trade and investment.

In Argentina, the decline in earnings inequality seems to be associated with government policies that without the windfall of high commodity prices will be hard to sustain…..”

 

 

*      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
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Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.