Federalism And Decentralization In Health Care

Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines the overall organization of the health system.

This is the first book to examine the processes of territorial federalization and decentralization of health systems in Europe drawing from an interdisciplinary economics, public policy and political science approach. It contains key theoretical and empirical features that allow an understanding of when health care decentralization is successful.

An examination of whether federal institutions influence policy outcomes in the health sector.

In the ongoing struggle between those favoring centralized and those favoring decentralized government, health care policy is an important issue. This book has three goals: (1) to illustrate how theories of federalism and intergovernmental relations can provide a useful framework for examining how to "divide up the job" in the health care area, (2) to assess the capacity of the states to actually implement health care policy changes, and (3) to weigh the merits of alternative visions of the future role of states and the federal government in health care policy.

Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.

This book explores the implications of a wide range of intergovernmental fiscal arrangements found in fiscal federal systems and how they impact on the equitable distribution of primary health care resources. The issues raised in the book are relevant to all countries operating under a fiscal federal system and those that operate a decentralized health system.

Now that Ottawa has left health care to the provinces, what is the future for Canadian health care in a decentralized federal context? Is the Canada Health Act dead? Health Care Federalism in Canada provides a multi-perspective, interdisciplinary analysis of a critical juncture in Canadian public policy and the contributing factors which have led to this point. Social scientists, legal scholars, health services researchers, and decision-makers examine the shift from a system where Ottawa has played a significant, sometimes controversial role, to one where provinces have more ability to push health care design in new directions. Will this change inspire innovation and collaboration, or inequality and confusion? Providing an up-to-date analysis of health care policy and intergovernmental relations at a crucial time, Health Care Federalism in Canada will be of interest to anyone concerned with the current dynamics and future potential of Canadian health care. Contributors include Greg Marchildon (Canada Research Chair at the Johnson-Shoyama Graduate School of Public Policy in Saskatchewan), Ken Boessenkool (public affairs strategist and former political advisor to Stephen Harper), Adrian Levy (Professor and Head, Department of Community Health and Epidemiology at Dalhousie University), Boris Sobolev (Canada Research Chair at the School of Public and Population Health, University of British Columbia), Gail Tomblin Murphy (Director, WHO Collaborating Centre for Health Workforce Planning and Research), and David Haardt (Department of Economics, Dalhousie University).

Examining the changing nature of health care federalism within a competitive global context, Comparative Health Care Federalism provides a rich and nuanced account of the way in which the interplay of federal relationships impact health care within an array of systems. The editors have gathered together some of the leading international health policy scholars to provide detailed accounts of the dynamics of federal health policy-making within their respective jurisdictions. Complementing the theoretical and methodological objectives, this book provides a detailed, empirical description of the challenges faced by different states and the ways in which health policy-making works within the federal, quasi-federal, and functional federal systems presented. In chapters on the United States, Australia, Canada, Germany, Spain, Italy, Austria, the United Kingdom, the EU, India, China, Brazil, and the Russian Federation the authors consider what variables contribute to, and stand in the way of, the formation of robust and sustainable health care systems.