Croatian medical journal
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To examine the Canadian health system, in particular as it relates to health care, and to assess the functions of the provincial and federal governments in relation to health care, spending, funding, and reform. ⋯ The benefits of our system can be seen in the favorable health status of Canadians. Canada has been successful in its efforts to contain health expenditures and begin the process of reallocating resources. Health care is recognized as only one element of a larger health system, encompassing a broader range of services, providers, and delivery sites.
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This paper (a) provides a methodological taxonomy of pricing, financing, reimbursement, and cost containment methodologies for pharmaceuticals; (b) analyzes complex agency relationships and the health versus industrial policy tradeoff; (c) pinpoints financing measures to balance safety and effectiveness of medicines and their affordability by publicly funded systems in transition; and (d) highlights viable options for policy-makers for the financing of pharmaceuticals in transition. Three categories of measures and their implications for pharmaceutical policy cost containing are analyzed: supply-side measures, targeting manufacturers, proxy demand-side measures, targeting physicians and pharmacists, and demand-side measures, targeting patients. In pursuing supply side measures, we explore free pricing for pharmaceuticals, direct price controls, cost-plus and cost pricing, average pricing and international price comparisons, profit control, reference pricing, the introduction of a fourth hurdle, positive and negative lists, and other price control measures. ⋯ Global policies should operate simultaneously on the supply, the proxy demand, and the demand-side. Policy-making needs to have a continuous long-term planning. The importation of policies into transition economy may require extensive and expensive adaptation, and/or lead to sub-optimal policy outcomes.
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Croatian medical journal · Mar 1999
Historical ArticleTeaching history of medicine in the perspective of "medical humanities".
The current interest in philosophical questions and ethical aspects of medicine turns attention towards the past and obtains suggestions and perspectives from previous descriptions and interpretations of sickness, therapy, and the relation between the patient and physician. Culture as therapy and therapy as culture are fundamental challenges for the present; physician, patient, and society, i.e., humans and humane medicine, need this dialogue, which should also be constitutive for teaching history of medicine. ⋯ In the course of modern history, there have been several reactions aimed at overcoming these one-sided tendencies: in the Renaissance, in the epoch of Romanticism and Idealism, and at the beginning and the end of the 19th century. This article outlines, with historical examples and contemporary reflections, the concept of teaching history of medicine in the perspective of "medical humanities".
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Croatian medical journal · Mar 1999
Biography Historical ArticleDr Ivan Pintar and his contribution to the development of history of medicine in Slovenia.
The Medical School of the Ljubljana University has a long lasting tradition in teaching the history of medicine. Since 1934, all students of medicine and dentistry in Slovenia have attended the courses in history of medicine which were and still are mandatory. The first years of lectures on the history of medicine at the Ljubljana University Medical School coincided with the struggle for the establishment and recognition of a full medical curriculum in Slovenia. ⋯ He paved the way for the new generation of medical historians in Slovenia. Owing to him, contemporary Slovene physicians and dentists are aware of the importance of professional tradition. They know how to use the past experiences for new achievements.
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Croatian medical journal · Sep 1998
Priority setting and scarce resources: case of the Federation of Bosnia and Herzegovina.
The priority setting within the context of scarce resources in the Federation of Bosnia and Herzegovina (BH) can be divided into priorities within the health care services provision and priorities within the reconstruction process. Facing the resource scarcity, the Federation of BH has chosen to increase health insurance contribution rate to establish cost-sharing arrangements (co-payments) and priority setting to ration access to certain services funded by the compulsory health insurance ("basic package" of the health care services). Reconstruction process of the health care facilities is conducted on the federal level through the effective managerial infrastructure ("project implementation units"). This study reports on the consequences of the war in BH as a peculiar context of the overall reform objectives and priority setting.