Health Systems & Reform最新文献

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Reflections from South Africa on the Value and Application of a Political Economy Lens for Health Financing Reform 南非对政治经济学视角在卫生筹资改革中的价值和应用的思考
IF 4.1 3区 医学
Health Systems & Reform Pub Date : 2019-07-03 DOI: 10.1080/23288604.2019.1634382
L. Gilson
{"title":"Reflections from South Africa on the Value and Application of a Political Economy Lens for Health Financing Reform","authors":"L. Gilson","doi":"10.1080/23288604.2019.1634382","DOIUrl":"https://doi.org/10.1080/23288604.2019.1634382","url":null,"abstract":"In the mid-1990s Michael Reich and Gill Walt, drawing on independent lines of work, called for an injection of political economy thinking into health policy analysis in lowand middle-income countries (LMICs). Reich noted that “policy reform is inevitably political because it seeks to change who gets valued goods in society” and Walt, that health policy is “concerned with who influences whom in the making of policy, and how that happens. Both concluded that neither primarily technicalwork, such as economic analysis, nor awelldesigned policy are themselves enough to bring about policy change. Rather, deliberate and specific analysis of the wider political forces, the actors, processes and power, influencing such change is necessary to understand its political feasibility —and to consider how to support the process of change. As we approach 2020, the call for Universal Health Coverage (UHC) has ensured that health financing reform is on policy agendas around the world. Such large-scale health financing and system reform is quintessentially political—given that interests compete, there is much to gain and lose, and the current institutional status quo is inevitably challenged. It is no surprise that health financing reform is being contested and debated in parliaments as well as publicly from the highest to lowest income countries. Yet, there remains barely any political economy analysis of health financing reform in LMICs. Although there is no current mapping of literature in the field, only 13 out of 100 exemplar papers included in the 2018 LMIC Health Policy Analysis Reader had an explicit focus on financing policy. Earlier mapping reviews have demonstrated the small and fragmented nature of the overall field, and its limited consideration of health financing issues. In an overall field review for 1994–2007, only 15 out of 164 empirical papers addressed such issues and over","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"11 1","pages":"236 - 243"},"PeriodicalIF":4.1,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87833442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Political Economy of Reform under US Federalism: Adopting Single-Payer Health Coverage in New York State 美国联邦制下改革的政治经济学:纽约州采用单一付款人医疗保险
IF 4.1 3区 医学
Health Systems & Reform Pub Date : 2019-07-03 DOI: 10.1080/23288604.2019.1635414
Ashley M. Fox, Yongjin Choi
{"title":"Political Economy of Reform under US Federalism: Adopting Single-Payer Health Coverage in New York State","authors":"Ashley M. Fox, Yongjin Choi","doi":"10.1080/23288604.2019.1635414","DOIUrl":"https://doi.org/10.1080/23288604.2019.1635414","url":null,"abstract":"Abstract The US remains the only high-income country that lacks a universal health financing system and instead relies on a fragmented system with the largest segment of the population receiving health insurance through private, voluntary employer-sponsored health insurance plans. While not “universal” in the sense of being mandatory and tax-financed, through a series of reforms, the US has managed to provide some form of health insurance coverage to 90% of the population. Yet, the high cost of this system, the insufficient coverage afforded to many, and continued concerns about equity have led to calls for a national health insurance program that can reduce costs across the board while providing high-quality coverage for all. Given the policy gridlock at the national level, the states have often sought to achieve universal health financing on their own, but these bills have met with little success so far. Why has the ideal of states as “laboratories of democracy” failed to produce policy change towards national health insurance? This article examines the prospects for the New York Health Act, a single-payer bill that would create a universal health financing plan for all New York State residents. Applying the Political Economy of Health Financing Framework, we analyze the politics of health reform in New York State and identify strategies to overcome opposition to this policy proposal. We find that while a clear political opportunity is in place, the prospects for adoption remain low given the power of symbolic politics and institutional inertia on the reform process.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"87 1","pages":"209 - 223"},"PeriodicalIF":4.1,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88469245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Leadership Politics and the Evolution of the Universal Health Insurance Reform in Peru 领导政治与秘鲁全民健康保险改革的演变
IF 4.1 3区 医学
Health Systems & Reform Pub Date : 2019-06-25 DOI: 10.1080/23288604.2019.1635415
Midori de Habich
{"title":"Leadership Politics and the Evolution of the Universal Health Insurance Reform in Peru","authors":"Midori de Habich","doi":"10.1080/23288604.2019.1635415","DOIUrl":"https://doi.org/10.1080/23288604.2019.1635415","url":null,"abstract":"Abstract Peru is now on a path toward achieving universal health coverage (UHC), with 87% of its population covered by health insurance. This paper describes the politics surrounding the agenda setting and policy formulation process that led up to the adoption of Peru’s Universal Health Coverage Act in 2009, which has been instrumental in expanding coverage. This reform established a mandatory health insurance system, which includes an Essential Health Benefit Package (Plan Esencial de Aseguramiento en Salud—PEAS) that is financed by three health insurance schemes (subsidized, contributory and semi-contributory). Collectively these schemes are intended to cover the entire population of Peru. In exploring the politics of the health reform process, the commentary applies the Political Economy of Health Financing Framework, presented in this special issue. It does so from the point of view of a participant in the reform process. Some broader lessons emerge that extend beyond Peru regarding the changing nature of the leadership roles in each phase of the policy cycle. In particular, the analysis highlights the importance of a consensus building process across a range of political stakeholders to set the health reform on the policy agenda and as well as to preemptively identify and resolve disagreements that might arise in the legislative phase.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"1 1","pages":"244 - 249"},"PeriodicalIF":4.1,"publicationDate":"2019-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86454753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Political Economy of Non-Communicable Diseases: From Unconventional to Essential 非传染性疾病的政治经济学:从非常规到必要
IF 4.1 3区 医学
Health Systems & Reform Pub Date : 2019-05-03 DOI: 10.1080/23288604.2019.1609872
M. Reich
{"title":"Political Economy of Non-Communicable Diseases: From Unconventional to Essential","authors":"M. Reich","doi":"10.1080/23288604.2019.1609872","DOIUrl":"https://doi.org/10.1080/23288604.2019.1609872","url":null,"abstract":"In January 2019, the Prince Mahidol Award Conference organized an international meeting on “the political economy of non-communicable diseases”—the first major global health symposium to include political economy in its title and as its frame for discussion. This commentary is based on a plenary presentation made at the start of the conference. The overall goal of PMAC 2019was “to foster and enhance global momentum for NCD prevention and control,” using a political economy perspective. The organizers called this “an unconventional outlook.” This commentary argues that political economy should become viewed as a conventional, indeed, an essential outlook for NCDs, and more broadly for global health. Political economy factors are integral to the problems of NCDs and therefore must also be integral to the policy responses. I have often argued inmy career for more attention to political economy in public health—for more attention to the political dimensions of health policy, especially for lowand middleincome countries. This undoubtedly reflects my training as a political scientist. Political scientists constitute a tiny disciplinary club in global health. Just as health economists have a significant organization and a global meeting every two years in the International Health Economics Association, so too should political scientists engaged in health policy issues. The study of politics remains on the margins in the global health community, despite decades of scholarship on this topic, while economics and economic analysis are squarely situated at the center. PMAC 2019 contributed to placing political economy analysis more visibly at the core of debates on global health policy. While a prolonged discussion of the definition of political economy is not appropriate here, some consideration of definitions is necessary to ensure clarity. In general, most definitions of political economy focus on how the distributions of political and economic resources affect something we care about: inequality, economic growth, some specific policy, who controls a country, or health. The analysis of political economy typically involves consideration of power,","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"110 1","pages":"250 - 256"},"PeriodicalIF":4.1,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88963254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
When Both Markets and Governments Fail Health. 当市场和政府都不健康时。
IF 1.9 3区 医学
Health Systems & Reform Pub Date : 2019-01-01 Epub Date: 2019-11-04 DOI: 10.1080/23288604.2019.1660756
Abdo S Yazbeck, Agnès Soucat
{"title":"When Both Markets and Governments Fail Health.","authors":"Abdo S Yazbeck, Agnès Soucat","doi":"10.1080/23288604.2019.1660756","DOIUrl":"10.1080/23288604.2019.1660756","url":null,"abstract":"<p><p>This paper presents the rationale and motivation for countries and the global development community to tackle a critical set of functions in the health sector that appear to be under-prioritized and underfunded. The recent eruptions of Ebola outbreaks in Africa and other communicable diseases like Zika and SARS elsewhere led scientific and medical commissions to call for global action. The calls for action motivated the World Health Organization (WHO) to respond by defining a new construct within the health sector: Common Good for Health (CGH). While the starting point for developing the CGH construct was the re-emergence of communicable diseases, it extends to additional outcomes resulting from failures to act and finance within and outside the health sector. This paper summarizes global evidence on failures to address CGHs effectively, identifies potential reasons for the public and private sectors' failures to respond, and lays out the first phase of the WHO program as represented by the papers in this special issue of <i>Health Systems & Reform</i>.</p>","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"78 1","pages":"268-279"},"PeriodicalIF":1.9,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84286879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Financing Common Goods for Health: A Public Administration Perspective from India. 资助公共卫生产品:来自印度的公共行政视角。
IF 1.9 3区 医学
Health Systems & Reform Pub Date : 2019-01-01 Epub Date: 2019-10-29 DOI: 10.1080/23288604.2019.1652461
Ajay Shah, Sanhita Sapatnekar, Harleen Kaur, Shubho Roy
{"title":"Financing Common Goods for Health: A Public Administration Perspective from India.","authors":"Ajay Shah, Sanhita Sapatnekar, Harleen Kaur, Shubho Roy","doi":"10.1080/23288604.2019.1652461","DOIUrl":"10.1080/23288604.2019.1652461","url":null,"abstract":"","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"36 1","pages":"391-396"},"PeriodicalIF":1.9,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81327355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Financing Common Goods for Health in Liberia post-Ebola: Interview with Honorable Cllr. Tolbert Nyenswah. 为埃博拉后利比里亚的卫生共同产品融资:与Cllr阁下的访谈。托尔伯特Nyenswah。
IF 1.9 3区 医学
Health Systems & Reform Pub Date : 2019-01-01 Epub Date: 2019-10-16 DOI: 10.1080/23288604.2019.1649949
Alexandra J Earle, Susan P Sparkes
{"title":"Financing Common Goods for Health in Liberia post-Ebola: <i>Interview with Honorable Cllr. Tolbert Nyenswah</i>.","authors":"Alexandra J Earle, Susan P Sparkes","doi":"10.1080/23288604.2019.1649949","DOIUrl":"10.1080/23288604.2019.1649949","url":null,"abstract":"","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"1 1","pages":"387-390"},"PeriodicalIF":1.9,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91058497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction to Special Issue on Political Economy of Health Financing Reform. 《卫生筹资改革的政治经济学》特刊导论。
IF 1.9 3区 医学
Health Systems & Reform Pub Date : 2019-01-01 DOI: 10.1080/23288604.2019.1649915
Susan P Sparkes, Joseph Kutzin, Agnès Soucat, Jesse B Bump, Michael R Reich
{"title":"Introduction to Special Issue on Political Economy of Health Financing Reform.","authors":"Susan P Sparkes, Joseph Kutzin, Agnès Soucat, Jesse B Bump, Michael R Reich","doi":"10.1080/23288604.2019.1649915","DOIUrl":"10.1080/23288604.2019.1649915","url":null,"abstract":"","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"43 1","pages":"179-182"},"PeriodicalIF":1.9,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86958710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Political Economy Analysis for Health Financing Reform. 卫生筹资改革的政治经济学分析。
IF 1.9 3区 医学
Health Systems & Reform Pub Date : 2019-01-01 Epub Date: 2019-08-01 DOI: 10.1080/23288604.2019.1633874
Susan P Sparkes, Jesse B Bump, Ece A Özçelik, Joseph Kutzin, Michael R Reich
{"title":"Political Economy Analysis for Health Financing Reform.","authors":"Susan P Sparkes, Jesse B Bump, Ece A Özçelik, Joseph Kutzin, Michael R Reich","doi":"10.1080/23288604.2019.1633874","DOIUrl":"10.1080/23288604.2019.1633874","url":null,"abstract":"<p><p>Health financing reform is an inherently political process that alters the distribution of entitlements, responsibilities and resources across the health sector and beyond. As a result, changes in health financing policy affect a range of stakeholders and institutions in ways that can create political obstacles and tensions. As countries pursue health financing policies that support progress towards Universal Health Coverage, the analysis and management of these political concerns must be incorporated in reform processes. This article proposes an approach to political economy analysis to help policy makers develop more effective strategies for managing political challenges that arise in reform. Political economy analysis is used to assess the power and position of key political actors, as a way to develop strategies to change the political feasibility of desired reforms. Applying this approach to recent health financing reforms in Turkey and Mexico shows the importance of political economy factors in determining policy trajectories. In both cases, reform policies are analyzed according to the roles and positions of major categories of influential stakeholders: interest group politics, bureaucratic politics, budget politics, leadership politics, beneficiary politics, and external actor politics. The strategic responses to each political economy factor stress the connectedness of technical and political processes. Applying the approach to the two cases of Turkey and Mexico retrospectively shows its relevance for understanding reform experiences and its potential for helping decision makers manage reform processes prospectively. Moving forward, explicit political economy analysis can become an integral component of health financing reform processes to inform strategic responses and policy sequencing.</p>","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"52 1","pages":"183-194"},"PeriodicalIF":1.9,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88876785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Financing Common Goods for Health: Core Government Functions in Health Emergency and Disaster Risk Management. 资助公共卫生产品:政府在卫生应急和灾害风险管理中的核心职能。
IF 1.9 3区 医学
Health Systems & Reform Pub Date : 2019-01-01 Epub Date: 2019-10-29 DOI: 10.1080/23288604.2019.1660104
David H Peters, Odd Hanssen, Jose Gutierrez, Jonathan Abrahams, Tolbert Nyenswah
{"title":"Financing Common Goods for Health: Core Government Functions in Health Emergency and Disaster Risk Management.","authors":"David H Peters, Odd Hanssen, Jose Gutierrez, Jonathan Abrahams, Tolbert Nyenswah","doi":"10.1080/23288604.2019.1660104","DOIUrl":"10.1080/23288604.2019.1660104","url":null,"abstract":"<p><p>In the absence of good data on the costs and comparative benefits from investing in health emergency and disaster risk management (EDRM), governments have been reluctant to invest adequately in systems to reduce the risks and consequences of emergencies and disasters. Yet they spend heavily on their response. We describe a set of key functional areas for investment and action in health EDRM, and calculate the costs needed to establish and operate basic health EDRM services in low- and middle-income countries, focusing on management of epidemics and disasters from natural hazards.We find that health EDRM costs are affordable for most governments. They range from an additional 4.33 USD capital and 4.16 USD annual recurrent costs per capita in low-income countries to 1.35 USD capital to 1.41 USD recurrent costs in upper middle-income countries. These costs pale in comparison to the costs of not acting-the direct and indirect costs of epidemics and other emergencies from natural hazards are more than 20-fold higher.We also examine options for the institutional arrangements needed to design and implement health EDRM. We discuss the need for creating adaptive institutions, strengthening capacities of countries, communities and health systems for managing risks of emergencies, using \"all-of-society\" and \"all-of-state institutions\" approaches, and applying lessons about rules and regulations, behavioral norms, and organizational structures to better implement health EDRM. The economic and social value, and the feasibility of institutional options for implementing health EDRM systems should compel governments to invest in these common goods for health that strengthen national health security.</p>","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"25 1","pages":"307-321"},"PeriodicalIF":1.9,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72867140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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