Suchergebnisse

This paper examines the current health care reform issues in Canada. The provincial health insurance plans of the 1960s and 1970s had the untoward effects of limiting the federal government's clout for cost control and of promoting a system centered on inpatient and medical care. Recently, several provincial commissions reported that the current governance structures and management processes are outmoded in light of new knowledge, new fiscal realities and the evolution of power among stake-holders. They recommend decentralized governance and restructuring for better management and more citizen participation. Although Canada's health care system remains committed to safeguarding its guiding principles, the balance of power may be shifting from providers to citizens and "technocrats". Also, all provinces are likely to increase their pressure on physicians by means of salary caps, by exploring payment methods such as capitation, limiting access to costly technology, and by demanding practice changes based on evidence of cost-effectiveness. ; Este artículo examina los temas más recientes en las reformas del sistema de atención a la salud en Canadá. Los planes de seguridad en el sector salud durante los años sesenta y setenta tuvieron efectos inapropiados en cuanto a que limitaron el poder del gobierno federal para controlar costos y promover un sistema centrado en la atención médico-hospitalaria. Recientemente, varias comisiones provinciales reportaron que las actuales estructuras de gobierno y gestión de los procesos no están actualizadas en términos del nuevo conocimiento, las nuevas realidades fiscales y la evolución en las formas de poder entre los grupos de interés. Sus recomendaciones incluyen formas descentralizadas de gobierno y mayor participación ciudadana. A pesar de que el sistema de atención a la salud en Canadá permanece comprometido a garantizar sus principios centrales, el balance de poder estaría cambiando de los proveedores a los ciudadanos y "tecnócratas". Al mismo tiempo, es probable que todas ...

Safeguarding the Health Sector in Times of Macroeconomic Instability presents the results of an international initiative to document the effects of how health systems in the developing world have responded to macroeconomic austerity and adjustment measures. Are these systems flexible and resilient to changes or are they rigid? In which circumstances and under which conditions do health systems respond favourably or unfavourably? What are the success stories? Country studies from Burkina Faso, Zimbabwe, India, Thailand, Mexico, and Colombia discuss lessons learned and identify policy measures f

In many countries of the world, including Canada, arguments are made for a private-public mix in the financing and provision of health services. Proponents claim that such a mix would improve both access and quality of health care. Opponents counter that it would create a two-tiered system, narrowing the range of options available to the lower socioeconomic segments of society and ultimately harming the equitable delivery of quality health care. This book presents empirical evidence on this contentious and highly politicized issue. Uniquely, it integrates qualitative and quantitative analyses