Suchergebnisse

De senaste åren har sjukförsäkringen utvecklats i en åtstramande riktning utan att någon ändring av socialförsäkringsbalken har skett. Tidigare forskning har fokuserat på regeringens styrning mot ett sjukpenningtal på 9,0 som förklaring till Försäkringskassans förändrade tillämpning. Inom ramen för denna förklaring har även aktiveringspolitikens påverkan på styrningen lyfts fram. I denna artikel argumenterar jag för att det inte endast är regeringens styrning och aktiveringspolitiken som påverkat Försäkringskassans interna styrning, utan också en självideologi hos myndigheten som ligger i linje med ett ämbetsmannastatligt etos. Artikeln undersöker detta genom att göra en åtskillnad mellan enkelt respektivekvalificerat handlingsutrymme hos förvaltningen. Artikeln driver tesen att förändringen inom sjukförsäkringen har sin grund i en kombination av en ämbetsmannastatlig idé om relationen mellan politik och förvaltning (utövandet av ett kvalificerat handlingsutrymme) och en aktiveringspolitisk idé om relationen mellan stat och individ. ; Since the first two decades of the 21st century the Swedish social insurance system has evolved in a more restrictive direction without any corresponding change in the law. Previous research has mainly focused on the government's steering towards a sickness benefit ratio of 9.0 as an explanation to the changed enforcement of the system. Within the framework of this explanation, the activation policy has also been highlighted as a form of meta-ideology that has influenced the governance. This article argues that it's not only the government's control of activation policy that governs the actions of the Swedish social insurance agency, but also a specific ethos of the bureaucracy which consist of the self- ideology that the agency is the lord of the welfare state, not the server. In order to explore this, the article make a distinction between two types of discretion of the bureaucracy, and argue that the change in the Swedish social ...

The Swedish Social Insurance Agency is an important part of the Swedish welfare state. The Agency has recently made a number of major changes, such as establishing a new internal organization and reforming processes for decision making. Many of these changes have been controversial. Critics have complained that the Agency shows a lack of efficiency, has failed to make payments on time, and has been too harsh in its application of eligibility rules. The changes have put the agency at a number of crossroads, many of them recurring from earlier reforms, in dealing with problems such as regional differences in the application of rules. In this article, some of these choices are discussed. The discussion departs from four dichotomies: uniformity-local adaptation; centralization-decentralization; specialization-generalist approaches; and closeness-distance. These dichotomies are illustrated with examples from the agency. The general conclusion is that although the change process has taken a rocky road, there has been a great deal of internal consistency in the combination of measures taken.

Telemedicine is an innovative approach that helps alleviate the health disparity in developing countries and improve health service accessibility, affordability, and quality. Few studies have focused on the social and organizational issues involved in telemedicine, despite in-depth studies of and significant improvements in these technologies. This paper used evolutionary game theory to analyze behavioral strategies and their dynamic evolution in the implementation and operation of telemedicine. Further, numerical simulation was carried out to develop management strategies for promoting telemedicine as a new way of delivering health services. The results showed that: (1) When the benefits are greater than the costs, the higher medical institutions (HMIs), primary medical institutions (PMIs), and patients positively promote telemedicine with benign interactions; (2) when the costs are greater than the benefits, the stability strategy of HMIs, PMIs, and patients is, respectively, 'no efforts', 'no efforts', and 'non-acceptance'; and (3) promotion of telemedicine is influenced by the initial probability of the 'HMI efforts', 'PMI efforts', and 'patients' acceptance' strategy chosen by the three stakeholders, telemedicine costs, and the reimbursement ratio of such costs. Based on theoretical analysis, in order to verify the theoretical model, this paper introduces the case study of a telemedicine system integrated with health resources at provincial, municipal, county, and township level in Guizhou. The findings of the case study were consistent with the theoretical analysis. Therefore, the central Chinese government and local governments should pay attention to the running cost of MIs and provide financial support when the costs are greater than the benefits. At the same time, the government should raise awareness of telemedicine and increase participation by all three stakeholders. Lastly, in order to promote telemedicine effectively, it is recommended that telemedicine services are incorporated within the scope of medical insurance and the optimal reimbursement ratio is used.