Internal Markets, Management by Targets, and Quasi-Markets: An Analysis of Health Care Reforms in the English NHS

2015 ◽  
Vol 35 (1) ◽  
pp. 93-108 ◽  
Author(s):  
Kristian Niemietz
Keyword(s):  
Health Care ◽  
Health Care Reforms ◽  
Internal Markets

COST CONTAINMENT AND ACCESS TO CARE: THE SHANGHAI HEALTH CARE FINANCING MODEL

2008 ◽  
Vol 53 (01) ◽  
pp. 27-41 ◽  
Author(s):  
WEIZHEN DONG
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Cost Containment ◽  
Access To Health Care ◽  
Health Care Cost ◽  
Health Care Expenditure ◽  
Health Care Financing ◽  
Insurance Scheme ◽  
Health Care Reforms ◽  
Medical Savings Account

The medical savings account (MSA) model of health care financing is viewed as a health care cost containment strategy. Yet, health care expenditure in Shanghai has increased sharply since the adoption of the MSA system. This paper looks into the health care reforms in Shanghai, especially since the introduction of the MSA scheme. From the Labor Insurance Scheme and Government Insurance Scheme to the Medical Savings Account scheme, ordinary Shanghai residents have not benefited from the most recent health care reforms. They have found medical care much less affordable. Disparity in access to health care access has become more evident than ever. Meanwhile, health care cost has increased sharply. China has benefited from an emphasis on prevention and primary care, but the government's recent policies give a high priority to catastrophic disease. This is not a cost-effective approach. Shanghai's health care system needs to break socioeconomic class boundaries if it is to construct a harmonious society. Shanghai's decision makers and various stakeholders have the resources and wisdom to face the challenge.

Substantive Equality in South African Health Care: The Limits of Law

2000 ◽  
Vol 4 (2) ◽  
pp. 111-131 ◽  
Author(s):  
Charles Ngwena
Keyword(s):  
Health Care ◽  
South African ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Reforms ◽  
Structural Inequality ◽  
Care Services ◽  
Substantive Equality ◽  
African Health ◽  
Access To Health

The article considers the scope and limits of law as an instrument for facilitating equitable access to health care in South Africa. The focus is on exploring the extent to which the notion of substantive equality in access to health care services that is implicitly guaranteed by the Constitution and supported by current health care reforms, is realisable for patients seeking treatment. The article highlights the gap between the idea of substantive equality in the Constitution and the resources at the disposal of the health care sector and the country as a whole. It is submitted that though formal equality in access to health care services has been realised, substantive equality is currently unattainable, if it is attainable at all, on account of entrenched structural inequality, general poverty and a high burden of disease.

Micro-Level Analysis of Distributional Changes in Health Care Financing in Finland

1998 ◽  
Vol 3 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Jan Klavus ◽  
Unto Häkkinen
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Structural Changes ◽  
Health Care Expenditure ◽  
Health Care Financing ◽  
Simulated Data ◽  
Health Care Reforms ◽  
Income Data ◽  
Severe Recession ◽  
Care System

Objectives: In the early 1990s the Finnish economy suffered a severe recession at the same time as health care reforms were taking place. This study examines the effects of these changes on the distribution of contributions to health care financing in relation to household income. Explanations for changes in various indicators of health care expenditure and use during that time are offered. Method: The analysis is based partly on actual income data and partly on simulated data from the base year (1990). It employs methods that allow the estimation of confidence intervals for inequality indices (the Gini coefficient and Kakwani's progressivity index). Results: In spite of the substantial decrease in real incomes during the recession, the distribution of income remained almost unaltered. The share of total health care funding derived from poorer households increased somewhat, due purely to structural changes. The financial plight of the public sector led to the share of total funding from progressive income taxes to decrease, while regressive indirect taxes and direct payments by households contributed more. Conclusions: It seems that, aside from an increased financing burden on poorer households, Finland's health care system has withstood the tremendous changes of the early 1990s fairly well. This is largely attributable to the features of the tax-financed health care system, which apportions the effects of financial and functional disturbances equitably.

The British Health Care Reforms, the American Health Care Revolution, and Purchaser/Provider Contracts

1995 ◽  
Vol 20 (4) ◽  
pp. 885-908 ◽  
Author(s):  
Timothy Stoltzfus Jost ◽  
David Hughes ◽  
Jean McHale ◽  
Lesley Griffiths
Keyword(s):  
Health Care ◽  
Health Care Reforms ◽  
American Health Care ◽  
British Health
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