Policymakers around the world tend to conduct retrospective, often politically motivated reviews, cherry-picking programmes which seem to work, so they can report success to their superiors. 4. Australian Institute of Health Innovation, Level 6, 75 Talavera Rd, Macquarie University, Sydney, NSW 2109, Australia. Its individual components are not well integrated. If feasible, have a control group that does not receive the reform or improvement, to enable comparisons. Citizens of Canada sacrificed immediate access to a provider of their choice for the assurances that everyone would be covered but not necessarily at their beck and call. Unfortunately, the well-meaning plans currently presented to Congress are the wrong therapy because they mistake the symptoms for the underlying disease. *Based on a Lecture given at the John Radcliffe Hospital, University of Oxford on 6 October 2009. And South Africa not only carries a quadruple burden of disease—HIV/AIDS and tuberculosis, maternal and infant mortality, non-communicable diseases (NCDs), and violence and trauma—but faces hurdles that include “unacceptably high levels of fraud and theft, top-heavy management and administration structures, and an excessively hospi-centric and specialist focus”, according to Stuart Whittaker, Carol Marshall and Grace Labadarios [3]. In America, all of these models can be found in some form. J Community Health 19: 253–69. When one starts from a low base, the results of particular reforms can also be easier to measure. At the same time, evaluations should consider less tangible aspects of care such as compassion, dignity and respect. . Although insurance premiums have gone up for some, reports by the U.S. Department of Health and Human Services cite economic benefits for states and estimate that with more Americans insured, hospitals will face less uncompensated care, which accounted for billions of dollars in 2013. Scholarly Websites For Research . Sophisticated thinkers may go further and consider a stepped-wedge intervention, whereby the change enrols the entire population, but its introduction is staged, so the population becomes its own control [11]. Brown Herman MW (1984) Medical students' opinions concerning the health care system. T The major philosophical theories about justice, namely, libertarianism, utilitarianism, and liberal egalitarianism, generally accept that a society must in some way provide for its least advantaged members [13-16]. Learn more. Italy has introduced reform through new laws, new clinical standards and quality and patient safety improvements. Also conspicuously alike are the obstacles to change: shortages of finance and staff, medical profession politics and intransigence, poor infrastructure, organizational cultures riven with resistance to change, ineffective leadership and management or governance arrangements that are not fit for purpose. Previous books on the subject [1, 2], and initiatives such as the Commonwealth Fund, have tended to focus on the developed world. ‘Free at the point of delivery’ is a frequently repeated mantra. Behavioral Health Homes – DHS, with input from stakeholders, is working to design a behavioral health home model which will operate under a “whole person” philosophy and assure access to and coordinated delivery of primary care and behavioral health services for adults and children with serious mental illness. A third model also arose in the post-WW-II period in Canada, created first by Thomas ‘Tommie’ Douglas in the province of Saskatchewan in 1945 and Canada-wide in 1961 called Medicare. Underlying this post-passage debate is the very real and pervasive effect of a slowly reversing recession and continued high unemployment rates. Should healthcare reformers then, give up trying? We analyse the impact that these health-reform initiatives have had on the quality and safety of care in an international context—that is, in low-, middle- and high-income countries—Argentina, Australia, Brazil, Chile, China, Denmark, England, Ghana, Germany, the Gulf states, Hong Kong, India, Indonesia, Israel, Italy, Japan, Mexico, Myanmar, New Zealand, Norway, Oman, Papua New Guinea (PNG), South Africa, the USA, Scotland and Sweden. Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. The last of these justifiable criticisms has been, at least in part, corrected by the enactment of the new law. What the broadened access to medical care will do to the insurance industry, the public and private hospital systems and to a medical establishment already bereft of primary care providers can only be guessed. Medicare spending varies widely in America depending on health status, income level and other regional factors.3 A promise to slow the projected growth of the Medicare program may delay insolvency, but will be difficult to actually accomplish. Most health facilities lack running water and electricity, and, according to William Adu-Crow and Paulinus Lingani Ncube Sikosana, the system is officially described as “in crisis”. 10th International Conference on Hospital Management and Health Care, Webinar, Webinar: March 25-26, 2021 3rd Middle East Heart Congress, Dubai, UAE: March 30-31, 2021 2nd International Conference on Medical Education, Health Sciences and Patient Care, Webinar, Webinar: May 12-13, 2021 Maintenance of free choice of providers, preservation of physician autonomy and reform of the litigation system of injury from sub-standard care is also high on the agenda. Scholarly Articles On Healthcare . To answer these questions, we draw on a book we recently contributed, Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries.We analyse the impact that these health-reform initiatives have had on the quality and safety of care in an international context—that … The debate preceding the enactment of health care reform brought up numerous comparisons (often invidious and falsified) between the American system of health care and other systems throughout the world, including the National Health Service in the United Kingdom and Medicare in Canada. ; 5. Together, these can obstruct change. . The Bismarck model, as it is now known, uses a private but not-for-profit system of tightly regulated insurers jointly financed by employer and employee (or subsidized by the Federal government for the unemployed). 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