scholarly journals Achilles' Heels of Health Care Systems

2010 ◽  
Vol 10 (1) ◽  
pp. 21-40 ◽  
Author(s):  
Jan Mertl
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Private Insurance ◽  
Theoretical Background ◽  
Health Care Facilities ◽  
Public And Private ◽  
Private Providers ◽  
German Model ◽  
Care Systems ◽  
Privately Financed

Achilles' Heels of Health Care Systems The aim of this article is to research the organization of health care systems and their typical failures in relationship with the need for health care. It is based on extensive theoretical background from economics and social policy, where the concepts used have already been defined. It emphasizes the differences between public and private insurance, and the various models of health care. It shows waiting lists, deficits and not realized health care as inevitable attributes of particular model. While based theoretically, it pays attention to empirical evidence in countries that are the most similar to their theoretical incarnation, e. g. the British model of publicly financed government-owned health care facilities, German model of publicly financed private providers and the American model of privately financed private providers. Finally it discusses the question of convergence of health care systems and the possible way of solving the issues described.

scholarly journals Journey of the Patient With Melanoma: Understanding Resource Use and Bridging the Gap Between Dermatologist, Surgeon, and Oncologist in Different Health Care Systems

2019 ◽  
pp. 1-8
Author(s):  
Cássia Rita Pereira da Veiga ◽  
Claudimar Pereira da Veiga ◽  
Ana Paula Drummond-Lage ◽  
Alberto Julius Alves Wainstein ◽  
Andreia Cristina de Melo
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Health Resources ◽  
Medical Professionals ◽  
Public And Private ◽  
Patients With Cancer ◽  
Clinical Procedures ◽  
Care Systems

PURPOSE New scientific evidence has led to modifications in the clinical practice of handling melanoma. In health care systems, there is currently a wide variety of clinical procedures to treat cancer, and the various routes have different effects on the survival of patients with cancer. Thus, this article aimed to evaluate the journey of patients with melanoma in the public and private health care systems in Brazil from the viewpoint of different medical professionals involved in the diagnosis and treatment of the disease. The study also considers the resources used for the complete delivery cycle of health care at different stages of the evolution of melanoma. METHODS We conducted a behavioral study by applying a questionnaire to a group of medical professionals. A nonprobabilistic sampling method for convenience was used, justified by the heterogeneous national incidence and the limited availability of medical professionals who diagnose and treat melanoma. RESULTS The questionnaire was answered by 138 doctors, including doctors from the Brazilian states with the highest concentration of medical specialists and regions with a higher melanoma incidence. The results of this study have the potential to enrich our understanding of the reality of Brazilian health care systems and, at the same time, allow us to discuss the multiple ways in which professionals from diverse specialist fields understand and explain decision making in health care. CONCLUSION Health care decision making is complex and, among other factors, depends on the diversity of available health resources and the knowledge of which treatments provide the greatest benefit to patients and greatest value to the system as a whole. This work can inform debates and reflection that are applicable not only in Brazil, but also in various other countries with similar realities.

Health Care Policy in Argentina

2019 ◽  
Author(s):  
Giuseppe M. Messina
Keyword(s):  
Health Care ◽  
Health Care Policy ◽  
Private Insurance ◽  
Complex Structure ◽  
Occupational Status ◽  
Insurance Companies ◽  
Care Policy ◽  
Public And Private ◽  
Private Providers ◽  
Unequal Access

In Argentina, the provision of health care is divided into three components: a highly decentralized universal public sector, funded from general taxation; a constellation of compulsory collective insurance schemes, financed by contributions withdrawn from the salaries of workers in the formal labor market; and a system of private insurance companies used primarily by the middle and upper classes. Regarding the delivery of medical services, the configuration is mixed, as the weight of public and private providers is roughly equal. This complex structure, which derives from the historical development of particular institutions, produces high costs and unequal access to care according to a person’s geographical residence, occupational status, and purchasing power.

scholarly journals The importance of intervening in adult mental health services when patients are parents

2014 ◽  
Vol 3 (6) ◽  
pp. 56 ◽  
Author(s):  
Camilla Lauritzen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Systems ◽  
Theoretical Background ◽  
Parental Mental Illness ◽  
Adult Mental Health ◽  
Care Systems

This article addresses the issue of parental mental illness. The theoretical background and rationale for developing new routines to change clinical practice is described, suggesting a policy change in which a child focus is implemented in adult mental health services. Furthermore, proposed strategies that have the potential of being effective within existing health care systems are discussed.

scholarly journals Direct Costs of Dengue Hospitalization in Brazil: Public and Private Health Care Systems and Use of WHO Guidelines

2014 ◽  
Vol 8 (9) ◽  
pp. e3104 ◽  
Author(s):  
Alessandra A. Vieira Machado ◽  
Anderson Oliveira Estevan ◽  
Antonio Sales ◽  
Kelly Cristina da Silva Brabes ◽  
Júlio Croda ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Direct Costs ◽  
Private Health Care ◽  
Who Guidelines ◽  
Public And Private ◽  
Care Systems

Does greater Medicare HMO enrollment cause adverse selection into Medigap?

2005 ◽  
Vol 1 (1) ◽  
pp. 3-21 ◽  
Author(s):  
KATHERINE A. DESMOND ◽  
THOMAS RICE ◽  
PETER D. FOX
Keyword(s):  
Adverse Selection ◽  
Fixed Effects ◽  
Health Care Systems ◽  
Private Insurance ◽  
Public And Private ◽  
Supplemental Insurance ◽  
The Disabled ◽  
Care Systems ◽  
Eligibility Requirements ◽  
Instrumental Variables Approach

This paper examines the interaction between public and private insurance in the context of the US Medicare program, which serves those aged 65 and older as well as the disabled who meet specific eligibility requirements. Specifically, the paper examines the extent to which increasing enrollment in Medicare managed care (which provides more comprehensive coverage than basic Medicare) influences premiums in the privately purchased Medicare supplemental insurance market (called ‘Medigap’). We employ a fixed effects instrumental variables approach to analyze the association between premiums charged by two large Medigap insurers and Medicare HMO penetration rates, examining over 60 geographic areas during the period 1994–2000. It is hypothesized that greater Medicare HMO penetration will lead to adverse selection into the Medigap market, resulting in higher premiums. The findings suggest a moderate upward effect on premiums, with elasticities ranging from 0.09 to 0.25. Controlling for other factors, moving from a 12% to a 22% Medicare HMO penetration rate would raise average Medigap premiums from $1,314 to $1,615. We discuss the implications of these results with respect to the design of national health care systems that include both public and private insurers.

Is Canada odd? A comparison of European and Canadian approaches to choice and regulation of the public/private divide in health care

2010 ◽  
Vol 5 (3) ◽  
pp. 319-341 ◽  
Author(s):  
Colleen M. Flood ◽  
Amanda Haugan
Keyword(s):  
Health Care ◽  
Private Health Insurance ◽  
Health Care Systems ◽  
Publicly Funded ◽  
The Public ◽  
The Supreme Court ◽  
Care Systems ◽  
Active Debate ◽  
Per Se ◽  
Privately Financed

AbstractChoice is often touted as a means for change within health care systems. Yet ‘choice’, in this context, takes at least three distinct forms: choice between providers within a publicly funded health care system; choice between competing insurers within a universal plan; and, lastly, choice as between privately financed health care and universal public coverage. In Canada, it is this last form of choice that is under active debate; particularly in light of the Supreme Court of Canada’s decision inChaoulli, which found a regulation banning private health insurance for medically necessary care was unconstitutional. The argument is frequently made that Canada is an outlier from other countries in having regulation that effectively precludes this kind of choice. This issue is likely to become of concern again in upcoming constitutional challenges where applicants are looking to overturn through judicial challenges Canada’s medicare system. This article tests that argument of whether Canada truly is ‘odd’ from a comparative policy perspective by exploring regulation of choice of privately financed health care in several European countries – the Netherlands, Germany, Sweden, England and France. We highlight commonalities as well as differences, showing the extent to which these countries employ regulation to fetter growth of a large privately financed sector. The article’s thesis is that Canada, in employing more intrusive forms of regulation, is not an outlierper sebut at one point in a regulatory spectrum.

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