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Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines the overall organization of the health system.
Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.
This book explores the implications of a wide range of intergovernmental fiscal arrangements found in fiscal federal systems and how they impact on the equitable distribution of primary health care resources. The issues raised in the book are relevant to all countries operating under a fiscal federal system and those that operate a decentralized health system.
This comprehensive scholarly book on comparative federalism and the Covid-19 pandemic is written by some of the world’s leading federal scholars and national experts. The Covid-19 pandemic presented an unprecedented emergency for countries worldwide, including all those with a federal or hybrid-federal system of government, which account for more than 40 per cent of the world’s population. With case studies from 19 federal countries, this book explores the core elements of federalism that came to the fore in combatting the pandemic: the division of responsibilities (disaster management, health care, social welfare, and education), the need for centralisation, and intergovernmental relations and cooperation. As the pandemic struck federal countries at roughly the same time, it provided a unique opportunity for comparative research on the question of how the various federal systems responded. The authors adopt a multidisciplinary approach to question whether federalism has been a help or a hindrance in tackling the pandemic. The value of the book lies in understanding how the Covid-19 pandemic affected federal dynamics and how it may have changed them, as well as providing useful lessons for how to combat such pandemics in federal countries in the future. This book will be of great interest to students and scholars of politics and international relations, comparative federalism, health care, and disaster management. The Open Access version of this book, available at http://www.taylorfrancis.com, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.
"As James Madison led America's effort to write its Constitution, he made two great inventions-the separation of powers and federalism. The first is more famous, but the second was most essential because, without federalism, there could have been no United States of America. Federalism has always been about setting the balance of power between the federal government and the states-and that's revolved around deciding just how much inequality the country was prepared to accept in exchange for making piece among often-warring states. Through the course of its history, the country has moved through a series of phases, some of which put more power into the hands of the federal government, and some rested more power in the states. Sometimes this rebalancing led to armed conflict. The Civil War, of course, almost split the nation permanently apart. And sometimes it led to political battles. By the end of the 1960s, however, the country seemed to have settled into a quiet agreement that inequality was a prime national concern, that the federal government had the responsibility for addressing it through its own policies, and that the states would serve as administrative agents of that policy. But as that agreement seemed set, federalism drifted from national debate, just as the states began using their administrative role to push in very different directions. The result has been a rising tide of inequality, with the great invention that helped create the nation increasingly driving it apart"--
While health system decentralization is often associated with federations, there has been limited study on the connection between federalism and the organization of publicly financed or mandated health services. Federalism and Decentralization in Health Care examines eight federations that differ in terms of their geography, history and constitutional and political development. Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines constitutional responsibility for health care, the national laws establishing a right to health care, the predominant sources and organization of public revenues directed to health care, and the overall organization of the health system. In additional to these structural features, each country case study is subjected to a "decision space analysis" to determine the actual degree of health system decentralization. This involves determining whether national and subnational governments have narrow, moderate or broad discretion in their decisions on governance, access, human resources, health system organization and financing. This comparative approach highlights the similarities and differences among these federations. Offering reflections on recent trends in centralization or decentralizations for the health system as a whole, Federalism and Decentralization in Health Care, is a valuable resource for those studying health care policy in federal systems and especially those interested in comparative aspects of the topic.
In the period from 1970 to the early 1990s, Republican leaders launched three major reforms of the federal system. Although all three initiatives advanced decentralization as a goal, they were remarkably different in their policy objectives, philosophical assumptions, patterns of politics, and policy outcomes. Expanding and updating his acclaimed book, New Federalism: Intergovernmental Reform from Nixon to Reagan (1988), Timothy Conlan provides a comprehensive look at intergovernmental reform from Nixon to the 104th Congress. The stated objectives of Republican reformers evolved from rationalizing and decentralizing an activist government, to rolling back the welfare state, to replacing it altogether. Conlan first explains why conservatives have placed so much emphasis on federal reform in their domestic agendas. He then examines Nixon's New Federalism, including management reforms and revenue sharing; analyzes the policies and politics of the "Reagan revolution"; and reviews the legislative limitations and achievements of the 104th Congress. Finally, he traces the remarkable evolution of federalism reform politics and ideology during the past 30 years and provides alternative scenarios for the future of American federalism.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
"The book is very valuable as actual information about the health systems in the Nordic countries and the changes that have been made during the last two decades. It informs well both about the similarities within the 'Nordic Health Model' and the important differences that exist between the countries." Bo Könberg, County Governor, Former Minister of Health and Social Insurance in Sweden (1991-94) "This book is a rich, interesting and very useful document. I have been looking, for example, today for precise information on political governing which is not displayed anywhere else. It will be of importance in many aspects!" Johan Calltorp MD PhD, Professor of Health Policy and Management, The Nordic School of Public Health, Gotenburg "The publishing of this book about the Nordic health care systems is a major event for those interested not only in Nordic health policy and health systems but also for everybody interested in comparative health policy and health systems. It is the first book in its kind. It covers the four 'large' Nordic countries, Denmark, Norway, Sweden and Finland, and does so in a very systematically comparative way. The book is well organized, covers 'everything' and is analytically sophisticated." Ole Berg, nstitute of Health Management and health economics, University of Oslo, Norway This book examines recent patterns of health reform in Nordic health care systems, and the balance between stability and change in how these systems have developed. The health systems in Norway, Denmark, Sweden and Finland are investigated through detailed comparisons along a variety of policy-driven parameters. The following themes are explored: Politicians, patients, and professions Financing, production, and distribution The role of the primary health sector The role of public health Internal management mechanisms Impact of the European Union The book probes the impact of these topics and then contrasts the development across all four, allowing the reader to gain a sense of perspective both on the individual countries as well as on the region as a whole. The editors also explore the extent to which a Nordic Health Care Model exists, and the degree to which that model will continue to help explain the future direction of health policy-making in these four countries. An additional chapter on recent developments in Iceland completes the work. Contributors: Tinna L. Ásgeirsdóttir, Paula Blomquist, Johan Calltorp, Terje P. Hagen, Unto Häkkinen, Peter K. Jespersen, Pia M. Jonsson, Lars Erik Kjekshus, Allan Krasnik, Meri Larivaara, Juhani Lehto, Kalevi Luoma, Jon Magnussen, Dorte S. Martinsen, Pål E. Martinussen, Bård Paulsen, Clas Rehnberg, Ånen Ringard, Richard B. Saltman, Signild Vallgårda, Karsten Vrangbæk, Ulrika Winblad, Sirpa Wrede.