The engine or the caboose: health policy in developing countries

Abstract

GOLDSTEEN, R. L. et al. The engine or the caboose: health policy in developing countries. Rev. Saúde públ., S. Paulo, 24 : 523-7,1990.ABSTRACT: A discussion of health policy in developing countries is presented. It argues that developing countries must adopt a progressive approach to health policy which rejects the two-tiered system of public and private health care. However, it also points out that ideology is not sufficient to maintain support. A progressive health system must utilize administrative and social and behavioral sciences to achieve effectiveness and efficiency in health care delivery. It cannot ignore these goals any more than a private health care system can.

Centring anti‐oppressive justice: Re‐envisioning dentistry's social contract

“…This distinction can be seen specifically in how physicians and medical doctors view health and how dentists view health. 7 While physicians may be perceived as promoting the public good through the delivery of care, dentists have either perceived themselves or been perceived by society as functioning less to advance the public good and more their own, meaning they lack can fail at the foundational professional attribute or virtue of altruism. Dentists can be seen to embrace an entrepreneurial role in which the delivery of care is transactional with the individual patient; if dentists cause no harm, their obligations to society are left to the rules that guide the economy and less a social contract that centres on care.…”

“…In high‐income countries and especially in the United States, the social contract for healthcare providers is different, resulting in a chasm between whether health is a public good or a commodity that is subject to market forces. This distinction can be seen specifically in how physicians and medical doctors view health and how dentists view health 7 . While physicians may be perceived as promoting the public good through the delivery of care, dentists have either perceived themselves or been perceived by society as functioning less to advance the public good and more their own, meaning they lack can fail at the foundational professional attribute or virtue of altruism.…”