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An international look at the theory and practice of health service privatization. The book examines the restructuring of health care systems and argues that conflicts implicit in privatization will limit the extent to which any government can dismantle its health care services.
An analysis of the transition from universal, publicly funded health care to New Labour s application of market principles: a national institution reaching crisis point and a key lesson for those concerned with health care everywhere.
Privatizing Health Services in Africa analyzes the disappearance of public health in the form of state services in Africa, and the growth of a private market in health care that will serve primarily an urban elite. Meredeth Turshen considers the implications of introducing private insurance in countries with growing unemployment, a shrinking formal job sector, and a lack of social security programs or other safety nets. She debates the pros and cons of shifting the delivery of health services to the nongovernmental sector in the context of new concepts of the role of the state. Many of the schemes to privatize the purchase and sale of pharmaceuticals reverse decades of United Nations work challenging the power of the multinational drug industry. Turshen weighs these policy changes in light of the World Bank's eclipse of the World Health Organization as the premier UN health policy agency. Until now, no book has disputed the World Bank's plans to privatize health care in Africa. This is the first book-length analysis of policy changes in light of monetarism and globalization. Throughout the book, Turshen examines the implications of privatization for gender equity. She also provides a case study of Zimbabwe and comparative material from Malawi, Mozambique, and Zambia. Her study makes a contribution to current debates on the impact of structural adjustment policies on health and the design of health services in the Third World.
Universal, comprehensive health care, equally available to all and disconnected from income and the ability to pay, was the goal of the founders of the National Health Service. This book, by one of the NHS's most eloquent and passionate defenders, tells the story of how that ideal has been progressively eroded, and how the clock is being turned back to pre-NHS days, when health care was a commodity, fully available only to those with money. How this has come about-to the point where even the shrinking core of free NHS hospital services is being handed over to private providers at the taxpayers' expense-is still not widely understood, hidden behind slogans like "care in the community," "diversity" and "local ownership." Allyson Pollock demystifies these terms, and in doing so presents a clear and powerful analysis of the transition from a comprehensive and universal service to New Labour's "mixed economy of health care," in which hospitals with foundation status, loosely supervised by an independent regulator, will be run on largely market principles. The NHS remains popular, Pollock argues, precisely because it created the "freedom from fear" that its founders promised, and because its integrated, non-commercial character meant low costs and good medical practice. Restoring these values in today's health service has become an urgent necessity, and this book will be a key resource for everyone wishing to to bring this about.
This edited collection focuses on the global growth of privatisation and private sector medicine in both developed and lesser developed countries, and the impact of this on patients, health workers, managers and policy-makers. Drawing upon sociological theories, concepts and insights, as well as experts from several countries with extensive experience in researching the field either nationally or internationally, the collection offers a unique perspective on healthcare services and healthcare systems: a view from those trying to access healthcare services, working inside health systems, or responsible for managing and organising services. Collectively, the chapters contribute an international perspective on the navigation of healthcare systems, and addresses the growing salience of ‘choice’ between public and private medicine in a variety of different national systems and contexts.
A critical component of the nation's economic vitality is ensuring that all Americans can contribute and prosper. Such contributions presuppose an intentional focus on achieving the highest levels of health possible, which requires that conditions in communities, schools workplaces, and other settings promote health and address the social determinants of health for all community members. Many organizations, in both the private and public sectors, have been establishing partnerships to further healthy workplaces and health equity in general. Many are taking the lead in producing economic growth that is inclusive and responsive to the nation's diverse needs and populations. Increasingly, privateâ€"public partnerships are emerging as ways of doing business. Additionally, a variety of new developments in health, health care, and community benefits obligations that are part of the Affordable Care Act have contributed to this interest in economic growth and health and in the creation of new partnerships. To examine past successes and future opportunities, the National Academies of Sciences, Engineering, and Medicine held a workshop in November 2015. The workshop focused on the potential of the private sector to produce a triple bottom line: economic opportunity (including workforce development) and growth, healthy work and community environments, and improved employee health. At the same time, participants looked beyond the private sector to publicâ€"private partnerships and to public-sector actions that combine opportunities for economic growth and good health for all. This publication summarizes the presentations and discussions from the workshop.
Based on original research and analysis by a group of health policy experts and economists from across the world, this book analyzes the causes and consequences of the expanding global and local commercialization of health care. It argues for the necessity and possibility of effective policy responses to develop good quality, universally inclusive health systems worldwide. The book aims to contribute to a shift in the international 'common sense' in health policy towards a more humane, inclusive, egalitarian, and ethical framework for policy formulation.
Health service delivery is being restructured in both industrialised and developing countries. Public health scholars and policy makers in this volume show how this process is accelerating as a result of diverse factors including fiscal pressure, privatisation of infrastructure, and the impending renegotiation of the WTO General Agreement on Trade in Services (GATS). The key policy issues that arise concern the implications of these changes for access and equity in public health provision. The volume reviews the rapidly changing context in which financing health care and its relationship to globalization and privatisation are taking place. It examines the specific mechanisms and institutional processes involved. And it explores various contrasting experiences, including HMOs in the USA, Britain's NHS, social health insurance in Western Europe, developing countries, and Cuba.
A remarkable transformation in American health-care delivery and financing is taking place, led by the private sector. This transformation presents myriad new legal and regulatory questions that have received little scholarly attention. These issues receive balanced, critical coverage in this book, which is intended for health-care policymakers, hospital and managed care executives, lawyers, clinical practitioners, students of law, medicine and public health, and academic departments of economics, political science and sociology.