Health Policy Reform, National Variations and Globalization

Alt̀enstetter, Christa; Björkman, James Warner

doi:10.1007/978-1-349-25319-7

Cited by 37 publications

(11 citation statements)

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“…First, although it was promised that certainty would result because of the newly delineated roles and relationships, quite the opposite occurred marked by poor understanding among constituents of their roles within the health sector, uncertainty about designated tasks, and a reluctance to commit to policy implementation. These are problems that health reformers consistently face (Altenstetter and Bjorkman 1997), dictating that incrementalism often becomes the way forward. Second, where budgets were to have been restricted, they escalated.…”

Section: The 1993 Restructurings and Their Resultsmentioning

confidence: 98%

Big Bang and the Policy Prescription: Health Care Meets the Market in New Zealand

Gauld¹

2000

Journal of Health Politics, Policy and Law

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This article discusses events that led up to and the aftermath of New Zealand's radical health sector restructuring of 1993. It suggests that "big bang" policy change facilitated the introduction of a set of market-oriented ideas describable as a policy prescription. In general, the new system performed poorly, in keeping with problems of market failure endemic in health care. The system was subsequently restructured, and elements of the 1993 structures were repackaged through a series of incremental changes. Based on the New Zealand experience, big bang produces change but not necessarily a predictive model, and the policy prescription has been oversold.

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Section: The 1993 Restructurings and Their Resultsmentioning

confidence: 98%

Big Bang and the Policy Prescription: Health Care Meets the Market in New Zealand

Gauld¹

2000

Journal of Health Politics, Policy and Law

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“…The financial crisis has placed serious pressures on the European welfare states and national health systems, but analyses of the repercussions of previous experiences with conservative reforms in the 1980s and 90s suggest non-linear processes with both backward and forward trends. Pro-market rhetoric has been more intense than its implementation in practice, and the principle of solidarity and the health systems' public nature have not been seriously shaken 35,37,59,60,61 .…”

Section: Final Remarksmentioning

confidence: 99%

The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

Giovanella

Stegmüller

2014

Cad. Saúde Pública

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The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.

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“…Com base em critérios e fluxos definidos, e conforme a necessidade, encaminha para o especialista ou para o hospital, e recebe o retorno do paciente, responsabilizando-se pela coordenação dos cuidados. Medidas similares -trajetórias distintas Embora certa similaridade e convergência de medidas, bem como compartilhamento de contextos similares (econômico, setorial, epidemiológico) possam ser observados, as reformas, condicionadas pelo legado institucional e a estrutura sociopolítica setorial, percorreram diversas trajetórias, ocorreram em ritmos diferentes, e envolveram instituições e organizações distintas 21,53 .…”

Section: Expansão Do Leque De Funções E Serviços Ofertados No Primeirunclassified

A atenção primária à saúde nos países da União Européia: configurações e reformas organizacionais na década de 1990

Giovanella

2006

Cad. Saúde Pública

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Propósitos de contenção de gastos em saúde e exigências de mudanças no perfil epidemiológico, impulsionaram durante a década de 90 reformas organizacionais dos serviços de atenção primária em países da União Européia, com o objetivo de promover a coordenação dos serviços prestados pelos diversos níveis de atenção. Neste artigo, a partir de revisão bibliográfica, análise documental e entrevistas com informantes-chave são analisadas as configurações institucionais do primeiro nível de atenção à saúde e discutidas as reformas organizacionais pró-coordenação nos países da União Européia. A atenção ambulatorial de primeiro nível é prestada nesses países com grande variedade de configurações institucionais, observando-se diferenciados mecanismos de financiamento, gama de profissionais envolvidos, espectro de serviços clínicos oferecidos e posição do profissional médico de atenção primária no sistema de saúde. Com as reformas da última década, ocorreu diversificação de modelos organizacionais da atenção ambulatorial com ampliação das funções clínicas, gerenciais de coordenação da atenção, e financeiras dos profissionais de atenção primária, indicando processo em transição com redefinição das funções do clínico geral como condutor dos cuidados ao paciente.

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Health Policy Reform, National Variations and Globalization

Cited by 37 publications

References 0 publications

Big Bang and the Policy Prescription: Health Care Meets the Market in New Zealand

Big Bang and the Policy Prescription: Health Care Meets the Market in New Zealand

The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

A atenção primária à saúde nos países da União Européia: configurações e reformas organizacionais na década de 1990

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