Health policy
-
Although not a member of the European Union (EU), Norway is part of the European internal market as a result of the European economic area (EEA) agreement. Before 1994, Norway had a distinctive set of arrangements for the licensing and distribution of medicines. Many of these have undergone considerable change as a result of European harmonisation. ⋯ New co-operatives have also arisen to increase the negotiating power of purchasers, particularly hospitals. Further significant changes are likely to occur in the Norwegian pharmaceutical sector in the future. The Norwegian case study provides an opportunity to look at the impact of European harmonisation on a particular set of regulatory arrangements and sheds light on the difficulty of implementing European policy in a national setting.
-
European Union (EU) policy on mobility requires ensuring healthcare access for EU residents who travel between EU states. This case-study investigates how this policy has been implemented in respect of EU visitors to the UK. EU visitors to the UK have similar access to 'immediately needed' National Health Service (NHS) healthcare to UK residents. ⋯ Research on health policy implementation mostly examines reasons for 'implementation failure'. However, the present study indicates a health policy being implemented more fully than policy-makers may have anticipated. In the case of healthcare access for EU visitors to the UK, an implementation surplus is evident rather than an implementation deficit.
-
Comparative Study
The context for health reform in the United Kingdom, Sweden, Germany, and the United States.
The success of health policy initiatives can be strongly influenced by the political, social, and cultural context within which a health care system operates. This study explores the similarities and differences in the background context of the four countries considered in this supplement: Sweden, the United Kingdom, Germany, and the United States. It concludes that there are considerable differences in the background context among these four countries, which help to explain their differing structural and organizational approaches to issues of pharmaceutical and home care policy.
-
Different approaches to health reform are proposed in many countries to overcome inefficiencies in care delivery. This paper assesses an incremental reform initiated in Spain 10 years ago, which sought to improve the efficiency of the entire health system through changes in the organization and delivery of primary care. ⋯ According to this study, aspects of care such as longitudinality and technical quality seemed improved with the reform, whereas other aspects such as accessibility and comprehensiveness remained unchanged. The authors conclude that system related characteristics (more associated with access and comprehensiveness) may be impeding the achievement of the goals of the reform and argue that attempts to encourage more autonomy of care delivery may be required.
-
Health systems throughout the world are searching for better ways of responding to present and future challenges. Latin America is no exception in this innovative process. Health systems in this region have to face a dual challenge: on the one hand, they must deal with a backlog of accumulated problems characteristic of underdeveloped societies; on the other hand, they are already facing a set of emerging problems characteristic of industrialized countries. ⋯ Finally, the delivery function would be open to pluralism that would be adapted to differential needs of urban and rural populations. After examining the convergence of various reform initiatives towards elements of the structured pluralism model, the paper reviews both the technical instruments and the political strategies for implementing changes. The worldwide health reform movement needs to sustain a systematic sharing of the unique learning opportunity that each reform experience represents.