Journal of health politics, policy and law
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J Health Polit Policy Law · Oct 2012
ReviewTackling the health divide in Europe: the role of the World Health Organization.
Europe faces major health challenges in addition to its well-reported economic and financial difficulties. Despite the overall improvement in population health, significant inequalities remain, with a growing gap between rich and poor. ⋯ Its success requires a whole-of-government and whole-of-society approach to improving health and well-being, informed by the latest evidence on cost-effective interventions. This review considers the prospects for success.
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J Health Polit Policy Law · Apr 2011
ReviewWhom do physicians work for? An analysis of dual practice in the health sector.
This article presents a thorough analysis of dual practice among physicians who work in both the public and private sectors. A conceptual framework is presented to help the reader understand dual practice and the contexts where it takes place. The article reviews the existing theoretical and empirical literature on this form of dual practice among physicians. ⋯ In this regard, the article provides some qualified support for the use of "rewarding" policies to retain physicians in the public sectors of more developed countries, while "limiting" policies are recommended for developing countries - with the caveat that the policies should be accompanied by the strengthening of institutional and contracting environments. The article highlights the lack of quality evaluative evidence regarding the consequences of dual practice on the delivery of health care services. It concludes that the overall impact of dual practice remains an open question that warrants more attention from researchers and policy makers alike.
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J Health Polit Policy Law · Apr 2000
Review Comparative StudyPhysicians' conflicts of interest in Japan and the United States: lessons for the United States.
Japanese health policy shows that even with physician ownership and the absence of for-profit, investor-owned health care, physicians' conflicts of interest thrive. Physician dispensing of drugs and ownership of hospitals and clinics were justified in Japan as ways to avoid commercialization of medicine. Instead, they create physicians' conflicts and fuel patient overuse of services. ⋯ In so doing, the United States creates new physicians' conflicts and reduces the role of countervailing incentives and power, an advantage of previous policy. Japan, in turn, has combined incentives to increase and decrease services, thus moving closer to the U. S. policy.
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J Health Polit Policy Law · Dec 1999
ReviewBarriers to achieving a cost-effective workforce mix: lessons from anesthesiology.
As pressures to control health care costs increase, competition among physicians, advanced practice nurses, and other allied health providers has also intensified. Anesthesia care is one of the most highly contested terrains, where the growth in anesthesiologist supply has far outstripped total demand. This article explains why the supply has grown so fast despite evidence that nurse anesthetists provide equally good care at a fraction of the cost. ⋯ HMO penetration and other market forces have begun signaling new domestic physician graduates to eschew anesthesia, but, again, Medicare payment incentives encourage teaching hospitals to recruit international medical graduates to maintain graduate medical education payments. After suggesting desirable but likely ineffective reforms involving licensure laws and hospital organizational restructuring, the article discusses several alternative payment methods that would encourage hospitals and medical staffs to adopt a more cost-effective anesthesia workforce mix. Lessons for other nonphysician personnel conclude the article.
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J Health Polit Policy Law · Feb 1999
ReviewOregon's bold experiment: whatever happened to rationing?
In 1994 Oregon began rationing health care for its Medicaid population, offering health policy makers and analysts around the country a view of one alternative future for health care delivery. The question now, four years after the experiment began, is what does that future look like? The short answer is that it does not look all that different from the present, but it looks different enough to offer important lessons to other states and the federal government. The Oregon experiment, including the prioritization of services and the aggressive use of managed care, has facilitated the expansion of health care coverage to over 100,000 additional Oregonians, helped decrease the percentage of the uninsured as well as reduce uncompensated care in hospitals, reduced the use of hospital emergency rooms, and reduced cost shifting. By most measures, the Oregon experiment appears to be a success.