Chapter 3. Medical Specialization as American Health Policy: Interweaving Public and Private Roles

2020 ◽  
pp. 49-80
Author(s):  
Rosemary A. Stevens
Keyword(s):  
Health Policy ◽  
Public And Private ◽  
Medical Specialization

Medical stratification in Vietnam

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Martha Lincoln
Keyword(s):  
Public Health ◽  
Health Disparities ◽  
Health Policy ◽  
Health Sector ◽  
Disease Outbreak ◽  
Market Transition ◽  
Government Employees ◽  
Public And Private ◽  
Ethnographic Interviews ◽  
The Social

Market transition in Vietnam is known to have fueled health disparities, but racialized and nationality-linked aspects of the country’s medical stratification have received less attention, despite the growing presence of foreigners using the health system. Field experiences reveal the country’s increasing health and medical inequity – legible in the social, linguistic, economic, and physical distinctions between public health stations staffed by government employees and the private clinics serving mostly expatriates. Ethnographic interviews and experiences of receiving care in both public and private facilities inform my argument that the privatization of Vietnam’s health sector produces racialized, classed, and citizenship-linked forms of medical profit, privilege, segregation, and risk – trends visible both in recent debates over US health policy and recent episodes of pandemic disease outbreak.

Pay scheme preferences and health policy objectives

2010 ◽  
Vol 6 (2) ◽  
pp. 157-173
Author(s):  
Birgit Abelsen
Keyword(s):  
Health Policy ◽  
Random Sample ◽  
Response Bias ◽  
Healthcare Workers ◽  
Healthcare Personnel ◽  
Income Risk ◽  
Public And Private ◽  
Policy Objectives ◽  
Different Levels ◽  
A Current

AbstractThis paper studies the preferences among healthcare workers towards pay schemes involving different levels of risk. It identifies which pay scheme individuals would prefer for themselves, and which they think is best in furthering health policy objectives. The paper adds, methodologically, a way of defining pay schemes that include different levels of risk. A questionnaire was mailed to a random sample of 1111 dentists. Respondents provided information about their current and preferred pay schemes, and indicated which pay scheme, in their opinion, would best further overall health policy objectives. A total of 504 dentists (45%) returned the questionnaire, and there was no indication of systematic non-response bias. All public dentists had a current pay scheme based on a fixed salary and the majority of individuals preferred a pay scheme with more income risk. Their preferred pay schemes coincided with the ones believed to further stabilise healthcare personnel. The predominant current pay scheme among private dentists was based solely on individual output, and the majority of respondents preferred this pay scheme. In addition, their preferred pay schemes coincided with the ones believed to further efficiency objectives. Both public and private dentists believed that pay schemes, furthering efficiency objectives, had to include more performance-related pay than the ones believed to further stability and quality objectives.

scholarly journals The engine or the caboose: health policy in developing countries

1990 ◽  
Vol 24 (6) ◽  
pp. 523-527
Author(s):  
Raymond L. Goldsteen ◽  
Julio Cesar R. Pereira ◽  
Karen Goldsteen
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Health Policy ◽  
Health System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Private Health Care ◽  
Public And Private ◽  
Tiered System ◽  
Effectiveness And Efficiency

A discussion of health policy in developing countries is presented. It argues that developing countries must adopt a progressive approach to health policy which rejects the two-tiered system of public and private health care. However, it also points out that ideology is not sufficient to maintain support. A progressive health system must utilize administrative and social and behavioral sciences to achieve effectiveness and efficiency in health care delivery. It cannot ignore these goals any more than a private health care system can.

scholarly journals POLÍTICA DE SAÚDE E ORGANIZAÇÕES SOCIAIS: limites para a consolidação da universalização da saúde no Rio de Janeiro

2016 ◽  
Vol 20 (1) ◽  
pp. 153
Author(s):  
Marcelo Augusto do Nascimento Muniz ◽  
Marcio Eduardo Brotto ◽  
Marcio Eduardo Brotto
Keyword(s):  
Health Policy ◽  
Social Relations ◽  
Rio De Janeiro ◽  
Health Management ◽  
Emergency Rooms ◽  
Corporate Structure ◽  
Public And Private ◽  
Public Language ◽  
Social Organizations ◽  
The Right

Historicamente, o debate em torno da política de saúde sempre representou uma das questões mais complexas e contraditórias no âmbito da questão social no Brasil. Neste sentido, podemos afirmar que a saúde é parte e expressão da estrutura macrossocietária e suas interfaces com a ordem capitalista hegemônica. A perspectiva de loteamento das urgências e emergências hospitalares no Rio de Janeiro revela a lógica de subordinação da saúde às relações sociais estabelecidas pela égide neoliberal, suscitando contradições entre público e privado, que colocam em xeque a linguagem pública dos direitos sociais em nome dos ideais mercantilistas. O presente estudo apresenta reflexões que apontam para a consolidação de um modelo de gestão na saúde, que privilegia a perspectiva privatizante dos serviços, fortalecendo a lógica de desconstrução do modelo de atendimento enquanto sistema único, além de incidir diretamente no direito de cidadania, provocando fraturas profundas no processo de construção da política de saúde. Palavras-chave: Saúde, Organizações sociais, Cidadania.HEALTH POLICY AND SOCIAL ORGANIZATIONS: limits for the consolidation of universal health in Rio de Janeiro Abstract: Historically, the debate over health policy has always represented one of the most complex and contradictory issues in the social question in Brazil. In this sense, we can say that health is part and expression of corporate structure and its interfaces with the hegemonic capitalist order. The prospect of allotment emergency rooms and hospital emergencies in Rio de Janeiro reveals the health subordination of logic to social relations established by neoliberal auspices, raising contradictions between public and private, which call into question the public language of social rights in the name of mercantilist ideals. This study presents reflections related to the consolidation of a health management model, which focuses on privatization perspective of services, strengthening the deconstruction of logic of the service model as a single system, and focus directly to the right of citizenship, causing deep fractures in the process of construction of a health policy. Key words: Health, Social organizations, Citizenship.

Analysing health and health policy: introducing the governmentality turn

2017 ◽  
Keyword(s):  
Health Policy ◽  
Welfare State ◽  
Health System ◽  
Welfare Regimes ◽  
Public And Private ◽  
Private Provision ◽  
Key Characteristics

This chapter introduces the twin central themes of the book: Irish health policy and the concept of governmentality. It explores key characteristics associated with Foucault and others’ exposition of the governmental approach and asks what such an analysis can add to already-existing analyses of Ireland’s health and healthcare agenda, whilst remaining cognisant of its criticisms. The chapter also discusses Ireland’s health system – and Irish health policy – in the context of advanced neoliberal welfare regimes, and in so doing it highlights some of the specificities of the governance of Ireland’s health policy and practices that make it distinctive from other jurisdictions, not least its system of two-tier (public and private) provision, and the residual nature of its welfare state. Finally, the chapter introduces the key themes of the book and the specific chapters.

The United Kingdom

2021 ◽  
pp. 115-156
Author(s):  
Jane Gingrich ◽  
Scott L. Greer
Keyword(s):  
United Kingdom ◽  
Health Policy ◽  
Northern Ireland ◽  
Outpatient Care ◽  
Central Government ◽  
Managerial Control ◽  
Public And Private ◽  
Health Politics ◽  
Policy Structure ◽  
The United Kingdom

This chapter looks at health politics and the comprehensive, tax-funded (largely free at point of service) health system in the United Kingdom and its four constituent countries, England, Northern Ireland, Scotland, and Wales. It traces the development of the UK’s healthcare system from an originally plural structure to a single National Health Service and then a devolved health policy structure. Though the NHS has continued to be highly popular and politically salient, the structure of care has substantially changed since 1948 as a result of reforms, with the growth of central government regulatory and managerial control, increasing competition in service delivery, more structured incentives for both GPs and hospitals, and a blurring of public and private boundaries in the provision of some outpatient care. As the chapter shows, the NHS’s devolution in 1999 has resulted in an increasingly diverging set of pathways across the four countries.

Exploring Theory for Citizens’ Preferences in Health Policy

2012 ◽  
Vol 2 (2) ◽  
pp. 38-57 ◽  
Author(s):  
Marika Kylänen ◽  
Jari Vuori ◽  
Pauline Allen
Keyword(s):  
Health Policy ◽  
Health Service ◽  
Service Providers ◽  
Health Service Delivery ◽  
Public And Private ◽  
Health Service Providers ◽  
Health Policy Analysis ◽  
Informed Preferences ◽  
Allocation Decisions ◽  
Policy Cultures

Preferences have been analyzed extensively in health care, but few studies have examined how culture driven preference formation may impact on resource allocation decisions in public and private health service delivery. This paper explores and develops a theoretical framework that distinguishes different approaches to institutionally and culturally informed preferences. The analysis shows that the appropriate approach depends on normative considerations and the particular health policy context which it is applied. In particular health policy cultures, mediating culture driven preferences (such as fatalism, hierarchism, individualism, egalitarianism and autonomy) which have not been used as part of health policy analysis before, challenge the roles of public and private health service providers. In view of the scarcity of studies in this field, the authors suggest a rationale for studies that enhance the understanding of how health policy cultures are embedded in normative health policy and propose a research agenda on cultural biases.

The Teacher and the Cop: The Role of ‘Private Space in Increasingly Transparent Clinical Practice

2012 ◽  
Vol 17 (1) ◽  
pp. 60-62
Author(s):  
Mark Exworthy ◽  
Peter Hockey1 ◽  
Alexandra Gilbert
Keyword(s):  
Health Policy ◽  
Clinical Practice ◽  
Patient Care ◽  
Clinical Performance ◽  
Public And Private ◽  
Private Space ◽  
Educational Perspective

Education and enforcement have been two contrasting ways of managing clinical performance. Both are needed but recently health policy has placed greater emphasis on the latter, possibly to the detriment of the former. This paper examines the ways in which education and other formative aspects of clinical practice can be conducted. The boundary between education and enforcement involves a distinction between public and private space. Private space is the territory within which clinicians can review their performance and improve it from an educational perspective. The boundary between public and private space is fluid, particularly since the advent of systems to ensure clinicians' competence. The sensitive management of this boundary will determine whether the benefits of transparent clinical practice will be realized in terms of improved patient care.

Sign in / Sign up

Export Citation Format

Share Document