International journal of health policy and management
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Int J Health Policy Manag · Oct 2015
CommentOptimisation of Healthcare Contracts: Tensions Between Standardisation and Innovation: Comment on "Competition in Healthcare: Good, Bad or Ugly?".
An important determinant of health system performance is contracting. Providers often respond to financial incentives, despite the ethical underpinnings of medicine, and payers can craft contracts to influence performance. Yet contracting is highly imperfect in both single-payer and multi-payer health systems. ⋯ This innovation in contract design could enhance performance. However, contractual innovation often fails to improve performance as payer incentives are misaligned with public policy objectives. Numerous countries seek to improve healthcare contracts, but thus far no health system has demonstrably crafted the necessary blend of incentives to stimulate optimal contracting.
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Int J Health Policy Manag · Oct 2015
EditorialEthical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage.
This article discusses what ethicists have called "unacceptable trade-offs" in health policy choices related to universal health coverage (UHC). Since the fiscal space is constrained, trade-offs need to be made. ⋯ Services of the latter kind include oral rehydration therapy for children with diarrhea and antibiotics for children with pneumonia. The article explains why such trade-offs are unfair and unacceptable even if political considerations may push in the opposite direction.