Croatian medical journal
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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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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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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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The introduction of health insurance system has been the core of the Russian health care reform. It has coincided with the decentralization of the state administration. ⋯ Meanwhile, the reform has had a positive stabilizing influence on financing of health care under conditions of continued economic crisis. The new priorities of the reform should be to balance the financial flows and the state's obligations, and to increase the efficiency of the use of resources through encouragement of competition, assurance of transparency of public funding, development of health care planning, and shift from inpatient to outpatient care.