How Would a Ban on Prescriber-Identifying Information Impact Pharmaceutical Marketing?

Recent legal proceedings have addressed pharmaceutical firms’ access to physician and brand level prescribing data. Proponents of the use of the data for marketing purposes claim constitutional protection as freedom of speech. Opponents maintain that distribution of the data compromises privacy. From the perspective of Granger-causality, this study investigates the extent to which pharmaceutical firms use this data to adjust detailing levels at the physician level. Important firm and public policy implications result. Consistent with the findings of previous work, detailing appears to Granger-cause prescription writing for a significant subset of physicians. However, the evidence that prescription writing Granger-causes adjustments in detailing levels is weak.

The Politics of Health Finance Reform in Hong Kong

Since the late 1950s, Hong Kong’s public health services have increased. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represented different, and even conflicting, values and interests. This paper describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.

Earthquake and Fukushima Nuclear Crisis in 2011 with Gender View

This article analyzes the Great East Japan Earthquake on the 11th of March in 2011 and Fukushima Nuclear Power Plant Accident with particular emphasis on gender aspects. The distortions of Japanese society that existed well before this disaster turned out to have a major impact on this crisis. The current situation is that women are unable to fully participate in the processes of planning for rehabilitation, recovery and reconstruction, and that their human rights are not being respected. What has society learned through this disaster is that problems that exist in normal times are exacerbated under the conditions of confusion and hardship that result from a disaster. After mapping the situation, the author proceeds to policy recommendations.

Risk Society and the Hybris of Modern Japanese State/Society

This article analyses the risk society discourse in the context of Japanese society and the triple shock of the earthquake, tsunami, and the Fukushima nuclear plants catastrophe. Social risk discourse has found its way to Japan but the reception has been rather selective. The policy examples in this article illustrate the obstacles that exist to promote greater social participation and social reforms in Japan.

Healthcare Providers in the English National Health Service

In recent years it has been noted that boundaries between public and private providers of many types of welfare have become blurred. This paper uses three dimensions of publicness to analyse this blurring of boundaries in relation to providers of healthcare in England. The authors find that, although most care is still funded and provided by the state, there are significant additional factors in respect of ownership and social control which indicate that many English healthcare providers are better understood as hybrids. Furthermore, the authors raise concerns about the possible deleterious effects of diminishing aspects of publicness on English healthcare. The most important of these is a decrease in accountability.

Outsourced Health Care Services

This paper provides answers to the question of how medical doctors and nurses at health centres narrate their experiences of outsourced health care services and make sense of their position in the new organization. The article contributes to the debate on the recent change in the marketization and transformation of health care organizations. The research material consists of seven group interviews with medical doctors and nurses. The method makes use of viewpoints from the narrative approach. The results of the analysis indicate that the workers interviewed are primarily rational professional actors. They do not actively take an emotional position. The short contracts between public or private actors mean that work processes in the outsourced health care organizations are intermittent. It may be necessary for the workers to adopt a strong professional identity without strong mental ties to the employer.

Comparative Study between Japan and the UK on Shifting the Third Sector–Government Relationships

The aim of this research is to examine and compare the shifting relationships between third sector organizations and local government under the current public service reforms in Japan and the UK. In both cases, institutional isomorphic tendency amongst third sector organizations can be found. However, in the case of UK, more formalized partnership frameworks set by central government as well as contractual relationships has an impact on this tendency. Contrastingly, Japan partnerships tend to be individualized. In this regard, the contracting framework seems to have more impact on behavior of the third sector organizations than partnership frameworks. In addition, the aspect of co-governance of the third sector organizations has been less developed than in the third sector in the UK. This affinity seems to be associated with the lack of sense of identity as a sector and also the lack of strong third sector organizations.

Changing Health Care from Inside Out

Finnish ophthalmology services have been criticized for being suboptimal and in this regard, the authors analyze a development project set up to reform these services. The project descended into crisis 18 months after its launch, when its actors mapped out two different ways in which they perceived the problems related to ophthalmology and came up with different solutions to these problems. This paper pays special attention to the events following the crisis, when an external policy entrepreneur was recruited to lead the project. This policy entrepreneur did not adhere to either of the realities mapped out in the earlier stages of the project, but created interpretation of the problems at hand and their solutions. This paper focuses on the process in which the policy entrepreneur strove to convince other actors of the validity perceived interpretations. According to the analyse, the implementation of the new policy alternative consisted not only of a technically and politically feasible solution, but it also involved skillful policy making and right timing.

Women and Health in Japan

In this article, the author first overviews the state of affairs concerning reproductive health/rights in Japan. The spread of HIV/AIDS and STIs (Sexually Transmitted Infections) in Japan are then examined, followed by a discussion on promotion of gender and sex-specific medicine. Finally, the author examines causes of death in Japan and their implications from the perspectives of gender equality.

Stakeholders’ Expectations on Health Services

Performance assessment in profit and not-for-profit organizations has been on the agenda for scholars and practitioners for the last thirty years or so. Despite this effort, a comprehensive model of organizational performance for all kinds of organizations does not exist. This paper aims to contribute to this field by presenting findings from a constructive and interpretative investigation carried out in public organizations at the local level. This research aims to identify the dimensions of performance that addresses stakeholder interests in public organizational performance. To this end, data was collected by semi structured interviews and analyzed using content analysis. The theoretical framework is based on resource dependence, institutional theory, agency theory, and social network theory. Evidence from the investigation indicates that stakeholders assess public service performance on criteria of efficiency, effectiveness, and equity. This paper provides practical and theoretical contributions by suggesting ways of assessing performance in public organizations, which can contribute to strategic planning by setting milestones related to stakeholder expectations and by defining the dimensions of stakeholders’ assessments of the performance of public service organizations.