Corporatization and Deprivatization of Health Services in Canada

1987 ◽  
Vol 17 (4) ◽  
pp. 567-584 ◽  
Author(s):  
Bruce J. Fried ◽  
Raisa B. Deber ◽  
Peggy Leatt
Keyword(s):  
Health Services ◽  
Structural Changes ◽  
Current System ◽  
The United States ◽  
Universal Health Insurance ◽  
Socioeconomic Groups ◽  
Government Involvement ◽  
Definition Of ◽  
Universal Health

Canada's system of health services has been shaped by the forces and values in the Canadian political, cultural, social, and economic environment; these forces continue to place constraints on future changes. We distinguish between “corporatization” and “privatization,” and the implications of each for improved efficiency of the system. Although the organization of health services is, in certain provinces, undergoing significant structural changes, there is evidence that rather than privatizing, the system may actually be continuing to experience what we have termed deprivatization, as the scope of government involvement expands to include a more comprehensive definition of health care. Trends in Canada differ considerably from those in the United States; universal health insurance has curbed the ability and desire of institutions to exclude members of some socioeconomic groups from receiving care. U.S.-based models, if applied to Canada, could lead to both higher costs and lower quality of care. Considerable efficiencies can be realized within Canada's current system.

BPJS Kesehatan Memberikan Jaminan Kesehatan Terhadap Pasien Atau Masyarakat

2021 ◽  
Vol 7 (2) ◽  
pp. 146-154
Author(s):  
Aidha Puteri Mustikasari
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
The State ◽  
Universal Health Care ◽  
Universal Health Insurance ◽  
Universal Health ◽  
Provide Health Insurance

Abstrak. Kepesertaan BPJS Kesehatan pada tahun 2020 tidak akan mencakup 90% penduduk Indonesia, namun rencana Universal Health Care Implementation (UHC) telah direncanakan sejak tahun sebelumnya. Di masa pandemi Covid, sejumlah besar status kepesertaan BPJS Kesehatan  dicabut karena terlambat, padahal masyarakat membutuhkan layanan kesehatan dan asuransi dengan kondisi yang ada. Kajian ini bersifat norma deskriptif , dibahas dalam konteks kepesertaan BPJS kesehatan, dan cukup  menggunakan prinsip asuransi dengan hanya memberikan jaminan kepada peserta, tetapi negara mengikuti kewajiban UUD 1945 yaitu memberikan jaminan kesehatan dan pelayanan kepada warga negara. Untuk mendukung keberadaan jaminan kesehatan universal, Indonesia perlu menerapkan formulir kepesertaan dan  sanksi untuk ketentuan wajib  peserta jaminan sosial yang efektif dan efisien. Abstract. BPJS Health membership in 2020 will not cover 90% of Indonesia's population, but the Universal Health Care Implementation (UHC) plan has been planned since the previous year. During the Covid pandemic, a large number of BPJS Health membership statuses were revoked because they were late, even though people needed health services and insurance with the existing conditions. This study is descriptive in nature, discussed in the context of BPJS health participation, and it is sufficient to use the insurance principle by only providing guarantees to participants, but the state follows the obligations of the 1945 Constitution, namely to provide health insurance and services to citizens. To support the existence of universal health insurance, Indonesia needs to implement an effective and efficient membership form and sanctions for mandatory provisions for social security participants.

scholarly journals Early diagnosis of COPD: myth or a true perspective

2020 ◽  
Vol 29 (158) ◽  
pp. 200131
Author(s):  
Maria Eugenia Laucho-Contreras ◽  
Mark Cohen-Todd
Keyword(s):  
Early Detection ◽  
Structural Changes ◽  
Critical Role ◽  
Management Strategies ◽  
Future Studies ◽  
Clinical Burden ◽  
History Of ◽  
Diagnostic Approaches ◽  
Definition Of

The early stages of COPD have recently become a hot topic as many new risk factors have been proposed, but substantial knowledge gaps remain in explaining the natural history of the disease. If we are to modify the outcomes of COPD, early detection needs to play a critical role. However, we need to sort out the barriers to early detection and have a better understanding of the definition of COPD and its diagnosis and therapeutic strategies to identify and treat patients with COPD before structural changes progress. In this review, we aim to clarify the differences between early COPD, mild COPD and early detection of COPD, with an emphasis on the clinical burden and how different outcomes (quality of life, exacerbation, cost and mortality) are modified depending on which definition is used. We will summarise the evidence for the new multidimensional diagnostic approaches to detecting early pathophysiologic changes that potentially allow for future studies on COPD management strategies to halt or prevent disease development.

Molecular and Structural Changes in the Cochlear Nucleus in Response to Hearing Loss

2018 ◽  
pp. 142-162
Author(s):  
Maria E. Rubio
Keyword(s):  
Hearing Loss ◽  
Cochlear Nucleus ◽  
Structural Changes ◽  
Auditory Pathway ◽  
The United States ◽  
Cellular Mechanisms ◽  
Auditory Experience ◽  
Central Auditory Pathway ◽  
The Brain

Hearing loss is the third most common health problem in the United States. It can affect the quality of life and relationships. About 48 million Americans have lost some hearing. Age, illness, and genetics contribute to the generation of hearing loss. During development, auditory synaptic circuitries are highly plastic and able to adapt to fluctuations in auditory experience. Whether this is so for mature auditory nerve synapses and circuitries within nuclei along the central auditory pathway is less understood. Daily fluctuations in auditory experience can lead to hearing deficits, including hearing loss and/or deafness, Therefore, understanding the cellular mechanisms that occur in mature central auditory synaptic circuitries that lead and/or contribute to hearing loss is important. This chapter focuses on published studies using animal models describing structural and molecular changes that occur in the cochlear nucleus in response to hearing loss, the first gateway of sound processing in the brain.

Winners and Losers of Universal Health Insurance: A Macroeconomic Analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Wung Lik Ng ◽  
Yin-Chi Wang
Keyword(s):  
Health Insurance ◽  
Service Sector ◽  
Medical Service ◽  
Specialty Choice ◽  
Universal Health Insurance ◽  
Overlapping Generations Model ◽  
Macroeconomic Analysis ◽  
The Cost ◽  
Universal Health

AbstractThis paper studies the supply-side distortions and the consequences resulted from provider-side cost containing universal health insurance (UHI) scheme. A two-sector overlapping generations model of endogenous physicians’ specialty choice is presented. We find that the general public is possible to be benefited from the cost containing UHI if the quality of medical services does not deteriorate too much. However, physicians in the medical service sector suffer from such scheme and end up earning lower incomes, regardless of one’s specialty and talent. Inequality among physicians also increases.

Quality of psychosocial care in oncology: A national survey of oncologists

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6561-6561
Author(s):  
W. F. Pirl ◽  
A. Muriel ◽  
V. Hwang ◽  
J. Greer ◽  
A. Kornblith ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Quality Care ◽  
Psychosocial Care ◽  
The United States ◽  
Routine Screening ◽  
Nccn Guidelines ◽  
Screening For Distress

6561 Background: Little is known about the quantity and quality of psychosocial care being delivered by oncologists in the United States. This study surveyed oncologists about their management of psychosocial distress, using the National Comprehensive Cancer Network (NCCN) guidelines for psychosocial distress as a standard. Availability of mental health services and routine screening for distress were used as measures of quality care. Methods: A random sample of 1,000 oncologists in the United States belonging to ASCO were surveyed with an anonymous e-mail and mail-based questionnaire between 9/05 and 7/06. Initial univariate analyses were used to test differences in frequencies among groups using Chi-square for categorical variables, and t-tests and ANOVA for continuous variables. Variables that were associated with reported routine screening at the .05 significance level in the univariate analyses were entered into a logistic regression model to determine independent predictors of screening. Results: Forty-six percent (448/965) of oncologists responded. Almost two-thirds (63.6%, 285/448) practiced in community settings, 27.2% (122/448) at cancer centers, and 6.9% (31/448) in hospitals. Only half (50.3%, 95% CI 45.7–54.9%; 225/448) reported having any mental health services affiliated with their practice. Availability differed by practice setting, with cancer centers having the most and community having the least (P<.001). Only one-third (32.3%, 144/445) reported being at least somewhat familiar with the NCCN guidelines. Two-thirds (65.0%, 95% CI 60.6–69.4%; 290/446) reported routinely screening for distress, but only 14.3% (64/447) use a screening instrument. Availability of mental health services, knowledge of NCCN guidelines, experience, time, certainty about identifying distress and being female were independent predictors of reported screening. Conclusion: Only 36.4% (95% CI 34.1–38.7%; 162/445) reported both of our measures of quality care, available mental health services and routine screening for distress. While the majority report routinely screening for distress, only a small percentage follow NCCN guidelines by using a screening instrument, and only half report having mental health services available. No significant financial relationships to disclose.

Healthcare Reform in the United States: Difficult Road

2015 ◽  
pp. 81-89
Author(s):  
G. Zeveleva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Healthcare System ◽  
Healthcare Reform ◽  
The United States ◽  
Universal Health Insurance ◽  
Federal Authority ◽  
Mandatory Health Insurance ◽  
The Usa ◽  
Universal Health

The article focuses on a healthcare reform, one of the pillars of Barack Obama’s presidency. The author argues that the reform was driven by social considerations, and the goal was to make the American healthcare system more just by implementing universal mandatory health insurance. The author analyses how implementation of Obama’s reform has turned into an arduous process, and why the enactment of some of its regulations were postponed. The article examines why some of the new regulations have already begun to function, while others are due to begin in 2018 and 2020. In 2014 the reform entered its critical phase, as its most controversial element on mandatory health insurance for all Americans came into effect. Failure to comply is met with the fine, while citizens with low incomes can rely on state support. Opponents of the reform are still undertaking efforts to eliminate the universal health insurance requirement. The author comes to the conclusion that despite the challenges Obama has already made the pages of history as the president who succeeded in implementing universal health insurance. One of his greatest achievements has been the triumph over many of the healthcare reform’s opponents as he wrote the reform into law in the spring of 2010. All previous attempts to reform the national system had been met with failure due to conservative resistance. The controversy around this topic stems from many Americans’ understanding of fundamental values. The central point of debate is not about the American healthcare system, but rather about what kind of country the United States of America will be in the 21st Century. Democrats believe that the reform will make the country more just, while their opponents fear that the USA will turn into a welfare state with less freedom and more control of federal authority.

Where Do We Go from Here: Is There Any Hope for Real Health Care Reform?

2004 ◽  
Vol 32 (3) ◽  
pp. 442-445
Author(s):  
Richard F. Southby
Keyword(s):  
Health Care ◽  
New York ◽  
Health Insurance ◽  
Health Care Reform ◽  
The United States ◽  
York Academy ◽  
Universal Health Insurance ◽  
Health Legislation ◽  
Near Future ◽  
Universal Health

As indicated in the title, the focus of this essay is on where we should go from here and not the how, which is addressed by other authors in this issue. I am assuming that there is probably a general consensus as to where we should be heading with health care reform, but there may well be some strong differences as to how this can or should be attained.In the summer of 1966, a year after the enactment of “Medicare,” I listened to Harry Becker, then the Executive Director of the New York Academy of Medicine, discuss the significance of the new health legislation and further changes that were likely in the near future. His analysis was that, after numerous attempts over many years, the United States was finally on the verge of implementing universal health insurance for all Americans. The next step would be health insurance for children, “Kiddicare.”

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