Journal of health politics, policy and law
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By virtue of the Supreme Court's decision on the constitutionality of the Patient Protection and Affordable Care Act, states may reject the law's expansion of Medicaid without losing all Medicaid funding from the federal government. The Court's ruling potentially permits a range of Medicaid options for states, including some that may be very attractive from state officials' political perspectives. In the context of the presidential campaign, the uncompensated care problem, and their concerns about costs of expansion, state officials are weighing their options, and some have already pledged to opt out of expansion. We argue that despite the politics, expansion is in fact good for patients, providers, and taxpayers, and states should therefore comply.
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J Health Polit Policy Law · Dec 2012
Comparative StudyVariation matters: epidemiological surveillance in Europe.
Communicable diseases do not respect national boundaries and are important challenges to health internationally. This article aims to support the improvement and integration of surveillance systems in Europe and beyond by drawing on research comparing national systems. Definitions and concepts of epidemiological surveillance are described as a continuous systematic process that observes and reflects the real situation in society not only within but also across political boundaries. ⋯ National surveillance systems from six European Union countries and from a later comparison of twenty-six European countries are examined. An effective surveillance system can provide information for action and act as a monitoring body for health authorities. Nevertheless, many European surveillance systems still require improvement in the interests of public health.
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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 · Aug 2012
Real reform begins within: an organizational approach to health care reform.
Health care systems are under pressure to control their increasing costs, to better adapt to evolving demands, to improve the quality and safety of care, and ultimately to ameliorate the health of their populations. This article looks at a battery of organizational options aimed at transforming health care systems and argues that more attention must be paid to reforming the delivery mechanisms that are so crucial for health care systems' overall performance. To support improvement, policies can rely on organizational assets in two ways. ⋯ The challenges confronting the development of more complete health care organizations are significant. Real health care system reforms may likewise require implementing ecologies of complex innovation at the clinical, organizational, and policy levels. Policies play a determining role in shaping these new spaces for action so that day-to-day practices may change.