Journal of public health policy
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J Public Health Policy · Jan 1996
Overcoming a powerful tobacco lobby in enacting local smoking ordinances: the Contra Costa County experience.
As part of a comprehensive tobacco education campaign, local health departments throughout California have been engaged in the process of enacting local clean indoor air ordinances to protect the public from the effects of secondhand smoke. This paper describes how a Northern California Bay Area health department worked with city and county governments to pass ordinances in the face of persistent tobacco industry opposition. ⋯ Tobacco industry tactics included establishing local front groups that launched a massive misinformation campaign to frighten local businesses into believing that passage of an ordinance would adversely affect their business. Finally, the authors discuss how the tobacco industry has created a climate through state and national legislative activity to undermine the ability of local health departments to pursue effective tobacco control policies, most notably through preemptive legislation.
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J Public Health Policy · Jan 1995
ReviewIn practice: the NHS market in the United Kingdom. Health Policy Network of the National Health Service Consultant's Association and the National Health Service Support Federation.
The National Health Service provides (and throughout its lifetime of nearly 47 years has provided) comprehensive health care of the highest professional quality at both primary and specialist levels and at very low cost whether expressed in terms of GDP or cash when compared with other industrialised countries. Until the NHS market was introduced, administrative overheads were also strikingly low, between 5% and 6% compared with at least 22% in the US. The legislation imposing the NHS market represents a fundamental reorganisation and fragmentation of the NHS into competing services with a new bureaucracy of business and financial managements topslicing funds for patient care. ⋯ We suggest how good effects associated with the introduction of the NHS market (such as giving GPs more say in the development of hospital services) could be enhanced without the side-effects inherent in the NHS market. We urge that ways of addressing these issues should, whenever possible, be piloted before they are introduced nationally. (In the case of fundholding in general practice, this damaging and controversial change should be halted and ways found to replace it with consortium commissioning, for which there is relevant experience.) We discuss the need to halt any other fundamental and potentially destabilising reorganisation before it has been tried out in properly evaluated pilot schemes. This should not, however, be allowed to become a recipe for stagnation as the health policy of the next government.
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J Public Health Policy · Jan 1992
Teaching health policy and politics in U.S. schools of public health.
Because most public health endeavors in the United States are funded by the public sector, public health practitioners need to be adept at working within the political system. However, the 1988 Institute of Medicine report, The Future of Public Health, found that many public health professionals are ignorant or disdainful of political processes and will not participate in activities that they perceive to be political. ⋯ Moreover, those students who do take health policy and politics courses study these areas within the context of health care delivery; the politics of public health and prevention are ignored by most schools of public health. Recommendations for improving public health curricula in health policy and politics are presented, including linkages with prevention activities.