International Health Care Reform

Reshaping Health Care in Latin America: A Comparative Analysis of Health Care Reform in Argentina, Brazil, and Mexico

This book offers a global perspective on healthcare reform and its relationship with efforts to improve quality and safety. It looks at the ways reforms have developed in 30 countries, and specifically the impact national reform initiatives have had on the quality and safety of care. It explores how reforms drive quality and safety improvement, and equally how they act to negate such goals. Every country included in this book is involved in a reform and improvement process, but each takes place in a particular social, cultural, economic and developmental context, leading to differing emphases and varied progress. Methods for tackling common problems - financing, efficiencies, effectiveness, evidence-based practice, institutional reforms, quality improvement, and patient safety initiatives - also differ. Representatives from each nation provide a chapter to convey their own situation. The editors draw a conclusion from these numerous contributions and synthesize the themes emerging into a coherent ’lessons learned’ summary that delivers value to the numerous stakeholders. Healthcare Reform, Quality and Safety forms a compendium of the current ’state of the art’ in global healthcare reform. This is the first book of its type, and offers a unique opportunity for cross-fertilization of ideas to the mutual benefit of countries involved in the project. The content will be of interest to governments, policymakers, managers and leaders, clinicians, teaching academics, researchers and students.

Health care reforms around the world—from Europe and North America to Africa, Latin America and Asia—seem to all be market-oriented reforms driven by international business interests and right wing political parties. There seems to be a sudden and broad concern with the efficiency of medical care, with the assertion that democratically or professionally run systems are inherently inefficient. Far less concern is evident for the more traditional values held regarding medical care, effectiveness (or quality) and equity. The fact is that we have little good cross-national research that systematically addresses the reform issue. This book addresses that problem, and attempts to look at health care reforms in a number of countries, representing as wide a spectrum as possible, and using a common conceptual framework that allows for comparable information to be gathered and presented on each, despite differing levels of socio-economic development. The authors agreed on a set of models that were thought to provide reasonable guidance in answering the questions of the source of pressures for reform, the alternative modes of organization that have been found in the world in recent years, and the direction of change among those alternatives.

This book presents the health reform experiences over the past three decades of twelve small and medium-sized nations that are not often included in international comparative studies in this field. The major conclusion of the study is that despite many similarities in policy goals, policy challenges and in the menu of policy options for countries that seek to offer universal coverage to their population, the health reforms of the nations in this book did not converge into one direction or model. However, we found several widespread policy experiences that are relevant for others, too.For example, user fees are unpopular everywhere. Governments often try to soften the consequences by exempting large groups of users, thus largely defeating the very purpose of those fees.As a second example, the introduction of new payment modes for medical care — like the shift from fee for service to case-based payment — took much longer than originally expected everywhere, and also failed to deliver their promises of improved transparency or efficiency gains A third example is that proposals are for universal coverage often ignore the challenges of implementing new financing models that elsewhere took decades if not centuries to develop.The conclusions contain both empirical findings and theoretical conclusions of interest to policy-makers and scholars of international comparison. It is accessible for academics, healthcare managers and students as well as a wider audience of readers interested in the changes in healthcare across the world.

This volume examines the two models of health care reform - managed competition and internal markets - that are increasingly becoming the dominant paradigm in European and North American policy.

This book analyses the wave of competition-oriented reform by comparing "internal market reform" (proposed in publicly-funded health care systems) with "managed competition reform" (proposed in systems with a mixture of public/private financing) and the role of "managed care" in each of these reform theories. International Health Care Reform clearly explains the arguments in economics and justice for intervention by governments in health care markets; the structure and dynamics of health care systems; and the features of competition-oriented reform models. The book will appeal to students and researchers involved in health policy studies, public health and health economics. It will also be a valuable read for policy-makers internationally.

"Comparing the health care systems of six industrialized nations - the United States, Canada, Germany, the Netherlands, Japan, and the United Kingdom - the author assesses the strengths and weaknesses of each system, discusses the latest in health care policy research, and suggests how the lessons learned by other nations might be applied in the United States to produce lasting health care reform."--BOOK JACKET.