Healthcare Politics and Policy in America

Author(s):  
Kant Patel ◽  
Mark Rushefsky
Keyword(s):  
2021 ◽  
pp. 652-676
Author(s):  
Christian Rüefli

This chapter offers an in-depth look at health politics and the mandatory health insurance system in Switzerland. It traces the development of the Swiss healthcare system, characterized by the strong role of the cantons and private stakeholder organizations in managing the system as well as the reliance on voluntary private insurance for most of the twentieth century. Since 1994, when a law on mandatory health insurance was adopted, the main issues in Swiss healthcare politics have been increasing costs, managed competition, the introduction of case-based payment, and healthcare governance. Switzerland’s consociational political system, with its instruments of direct democracy, federalism, and corporatist interest representation, impedes the development of consensus across the left–right divide about whether the health system should rely more on market mechanisms and individual responsibility or on state control and universal coverage.


Health Policy ◽  
2012 ◽  
Vol 107 (1) ◽  
pp. 11-20 ◽  
Author(s):  
Theodore Marmor ◽  
Claus Wendt

2013 ◽  
Vol 4 (1) ◽  
pp. 1-19 ◽  
Author(s):  
A. Sy

This paper seeks to analyze the problems and barriers encountered when public policy health programs are implemented within indigenous communities. The initial stumbling block for such programs is precisely the idea of health as a universal right, around which emerges a characterization and stereotype of the indigenous population who are consequently addressed as a homogenized unit subsisting below the poverty line, and marginalized. A result of this is that the  particular ethno-cultural register of such populations fails to be acknowledged and form part of a systematic public health policy. Consequently, health policies become generalized in character, unable to variate and differentiate according to the culturally specific contexts within which health outreach and access is needed. In this sense, based on the results of an ethnographic study carried out in two Mbya-Guaraní indigenous communities of Argentina, our study highlights as to how public policies of indigenous health are perceived, their impact value measured, and the meanings which emerge locally about the policy practices implemented.Lastly, our study identifies problems that can be avoided in fulfilling the goals of universal policies and certain questions to consider at the time of policy design and implementation.


4open ◽  
2019 ◽  
Vol 2 ◽  
pp. 3 ◽  
Author(s):  
Björn L.D.M. Brücher ◽  
Daniela Deufert

The shortage of nursing staff in Germany compromises public healthcare in deference to profits explaining why this is on the daily political and media agenda. In Germany, over a 22 year period, significant savings were achieved by decreases in: (1) hospital beds by −29.3% saving 119 000 beds, (2) patient care and treatment days by −23% saving 43.1 million patient days, and (3) length of hospital stay in days by −39% saving 4.7 days. This occurred together with the parallel increase of treated patient cases by +26.5% with an additional burden of 4.1 million patients. Since 2010, as birth rates increase again treatment cases will also increase. In parallel, the percentage of total nurses has decreased (−2.1%) as well as that of registered nurses in hospitals between 1999 (325 539) and 2009 (324 337) have decreased (−0.4%), in conjunction with nurses employed in preventive and rehabilitation facilities (+15.1%) and/or in outpatient care facilities (+41.1%) and/or nursing homes (+24.8%) and/or nurses working in retirement homes (+77.9%). This “profititis” endangers both patient care and detracts from people joining the nursing profession. It might even be a short-sighted tightrope act which, in the end, might counteract the marketing strategy of “patient safety” by risking quality of patient care. Maybe healthcare politics would be well-advised to re-think the fact that as the population gets older and as birth rates and immigration increases, these factors could result in increased patient caseloads in hospitals which need to be addressed now so as to avert a future crisis.


Kybernetes ◽  
2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Francisco X. Morales

PurposeIn a context of critical transition such as the COVID-19 pandemic, moral semantics take a prominent role as a form of self-description of society. However, they are not usually observed, but rather assumed as self-evident and necessarily “good.” The purpose of the article is to summarize the theory of morality from the social systems' perspective and illustrate with concrete examples the polemogenous nature of moral communication.Design/methodology/approachThis article presents an analysis of the role of morality in the context of the COVID-19 pandemic, from the perspective of Niklas Luhmann’s social systems theory. Applying the method of second-order observation, it describes three cases of moral semantics disseminated via mass media and social media, and it examines their connection with the structural situation of subsystems of society during the pandemic crisis (particularly healthcare, politics and science).FindingsSecond-order observation of moral communication demonstrates to be fruitful to describe the conditions and consequences in which moralization of communication occurs, particularly in a situation of critical transition around the healthcare crisis. The three examples examined, namely, the hero semantics directed to healthcare workers, the semantics of indiscipline and the controversies around pseudo-sciences and conspiracy theories, show how they are based on social attribution of esteem and disesteem, how they try to answer to troublesome situations and contradictions that seem difficult to cope, and how they are close related to the emergence of conflicts, even when they seem positive oriented and well intentioned.Originality/valueThis paper is an attempt to test the usefulness of Luhmann's theory of society to understand the ongoing COVID-19 crisis and particularly the role of moral communication in concrete examples.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030611
Author(s):  
Thimo Morro ◽  
Astrid Fink ◽  
Solveig Carmienke ◽  
Thomas Frese ◽  
Sebastian Guenther

IntroductionDiabetes mellitus (DM) has had a wide-ranging impact on healthcare politics. Secondary diseases and complications caused by diabetes are relevant cost and utilisation factors in the healthcare system. For decades, diabetes self-management education (DSME) has played a major role in the treatment of patients with type 2 DM (T2DM). The aim of this training is to empower patients to actively influence their diabetes process by gaining knowledge about health-related behaviours, such as healthy nutrition and exercise, and cardiovascular risks. The aim of the project is to analyse the practice of structured diabetes education and the effects of different learning types of participants. This project focuses on the needs of socioeconomically deprived patients and aims to improve DSME for this group. This patient group has a higher prevalence of T2DM, more complications and worse therapy-relevant parameters.Methods and analysisThe study will be conducted as a prospective longitudinal study. Patients will be recruited in outpatient physician offices over a period of 12 months. Patients will be included if they are 18 years and older, have T2DM and are scheduled to participate in DSME for the first time. A pseudonymised, written survey with standardised questionnaires will be administered. The data will be analysed using inferential statistical methods, such as correlation analysis, regression models and variance analytical designs.Ethics and disseminationThe study will be carried out following the principles of the Declaration of Helsinki and good scientific standards. Ethical approval of the Ethics Review Committee of the Medical Faculty at Martin-Luther-University, Halle-Wittenberg, was obtained. All participants in the study will receive comprehensive information and will be included after written informed consent is obtained. The results will be published in international peer-reviewed journals and presented at several congresses.Trial registration numberDRKS00016630


2017 ◽  
Vol 16 (1) ◽  
pp. 262 ◽  
Author(s):  
Marcelo Paula de Melo ◽  
Simone Eliza do Carmo Lessa

Considerando ser uma das expressões do projeto neoliberal de sociedade, expresso em projetos de reforma do Estado em diversos países, vislumbrado em documentos de organismos internacionais e intelectuais orgânicos das classes dominantes como forma de atuação estatal compatível com novos tempos, esse texto abordará expansão de entidades (supostamente) sem fins de lucro no Brasil, reconhecendo a presença do chamado Terceiro Setor renomeado como FASFIL nos Censos do IBGE. Nosso foco estará nas FASFILS do campo da saúde, apresentamos reflexão quali-quantitativa sobre os impactos desta experiência em franca expansão. Os desdobramentos dessas formas contemporâneas de privatização da ação estatal para as políticas sociais poderão ser apreendidos a partir da análise dessas entidades.


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