Towards a Competitive Health Care System

The antitrust laws constitute the foundation and fundamental strength of the U.S. democratic free enterprise system. Competition enhances both the democratic and economic opportunities, including in the healthcare markets. Although healthcare markets have significant market imperfections, a competitive system is more appropriate for the healthcare markets because it delivers choice among alternatives that regulation does not. Thus, the question to ask in the healthcare system is what can be done to make competition work better

The Lithuanian Long-term Care System

The remarkable growth of older population has moved long-term care to the front ranks of the social policy agenda in the European Union. This paper addresses the issue of the longterm care in Lithuania, its philosophy, the legal and funding regularities, management issues and LTC policy. Its attempt is also to provide a complex set of information about the demand side of long-term care including the demographic characteristics of people in need. The paper also presents a detailed description of types of LTC available. The results confirm that the main problem of the LTC system in Lithuania is still its division between the health care system and the social system and the weak integration of these two parts of LTC services. The formal LTC system in Lithuania is still biased towards the provision of institutional care, despite the fact that a number of social projects have started in order to expand the supply of semi-stationary LTC and care provided in homes. Moreover, most care provided to the elderly and disabled is still carried out by family, neighbours, friends and volunteers. The demand for LTC, approximated by the demographic and epidemiologic structure of the population at the national and regional levels, remains high and it is expected to increase. The middle-aged population’s longer average lifespan and progress in the field of medicine greatly contributes to an increasing number of disabled and older people who have difficulties in caring for themselves

Circles of Exclusion: The Politics of Health Care in Israel

Dr. Dani Filc delves into Israel\u27s health care system and provides numerous insights on how a private health care system undermines the principle of caring for the poor. Dr. Filc stresses that blind commitment to a for-profit health care system leads to wasted money and increased social inequity

The Lombardy Health Care System

In the very recent past, the Lombardy health care system - established on the quasi-market model – has caught the interest of researchers and politicians in different OECD countries1. The merits of the model, compared to other Italian regional models, are the control of health care spending and the balanced budget, in a frame of good quality of services and patient choice. This paper stems from a literature review and tries to analyse the evolution of this regional system, the institutional path that brought to the implementation of the model, its theoretical basis, its merits and criticism. The period considered ranges from 1997, when the reform was enacted, to 2010.quasi-market, health care system, Italian NHS reforms.

Trends in the National Foster Care System

Graduate Textual or Investigativ

The Barnardo's Safe Accommodation Project: consultation with young people

This report presents the findings of a consultation with young people in the care system affected by sexual exploitation or trafficking, conducted as part of the Barnardo's Safe Accommodation project. The consultation focused on experiences of the care system and how these could be improved

Explaining public satisfaction with health care systems: findings from a nationwide survey in China

Objective: To identify factors and covariates associated with health care system satisfaction in China. Context: Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health care utilization, media use and perceptions of services may affect health care system satisfaction, but the relationships between these factors are poorly understood. New data from China offers the opportunity to test theories about the sources of health care system satisfaction. Design: Stratified nationwide survey sample analysed using multilevel logistic regression. Setting and participants: 3,680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Main outcome measure: Satisfaction with the way the health care system in China is run. Results: We find only weak associations between satisfaction and socio-demographic characteristics, income and self-reported health. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. Conclusions: To improve satisfaction, Chinese policy makers – and their counterparts in countries with similar health care system characteristics – should improve insurance coverage and the quality of health services, and tackle unethical medical practices

Health Expenditure Scenarios in the New Member States – Comparative Report on Bulgaria, Estonia, Hungary, Poland and Slovakia. ENEPRI Research Reports No. 43, 19 December 2007

The objective of this comparative report is to present the model of future health care system revenues and expenditures in selected Central and Eastern European countries which are now the new EU member states, and to discuss projection assumptions and results. Health expenditure analysis and projections are based on the ILO social budget model, a part of which is the health budget model. The model covers health care system revenues and expenditures. It is suitable for the analysis of impact exerted by demography (especially ageing) on health care system revenues and expenditures. The objective of AHEAD project is to examine those factors. Up to date, data and information sources in new member states that could be used for the long-term comparative projections have been limited

Health Expenditure Scenarios in the New Member States: Country Report on Poland. ENEPRI Research Reports No. 47, 19 December 2007

The objective of this report is to present the model of future health care system revenues and expenditures in Poland, and to discuss assumptions for the projection and projection results. Expenditure analysis is based on ILO social budget model, part of which is health budget model. The model takes into account the revenue side of health care system as well, which is consistent with the above-mentioned discussion on health care system funding and its sustainability. The first part of the Report is dedicated to social, and especially health-related, expenditure models and projections applied in Poland. Following, detailed description of data and information used in the current projection is presented. Baseline projections of main demographic and macro-economic variables and indicators used in the model are shown, and the assumptions for the development of these indicators and their inter-relations are discussed. Three scenarios are presented: the baseline scenario, death-related costs scenario, and the scenario with different longevity improvements. Projection results cover both the revenue and the expenditure side of health care system. Finally, conclusions are made and policy recommendations are formulated, based on projection results

Reducing gender inequalities to create a sustainable care system

Women mainly provide family care, but as women’s economic opportunities increase they will not continue to bear the costs of providing care unaided. To create a sustainable care system, care and carers must be better supported and more highly valued to involve more men in caring and reduce gender inequalities.Key pointsMost care is still provided through family obligations, unpaid but not free, since it is ‘paid for’ by reduced opportunities for carers. Family carers are mostly women, because of gender norms and also the gender pay gap, which makes it more costly for men to reduce employment hours.As women move increasingly into employment, family carers’ demand for employment will continue to rise, as will the need for paid care. The UK’s long working hours make it difficult to combine caring with full-time employment, but part-time pay rates are often considerably lower.Four in five paid carers are women, in a sector having increasing difficulties with recruitment and retention. The care sector’s poor pay is a large contributor to the gender pay gap.Privatisation of residential and domiciliary care has produced a labour market with insufficient opportunities for training and career development. This is unlikely to attract men, and women will increasingly leave as their employment opportunities improve.This situation will be unsustainable for meeting society’s care needs unless:- pay and conditions improve to retain more women and encourage men to enter the care sector;- unpaid carers receive financial and other support, and working hours are reduced for all, so that more people can combine family care with employment;- cash payments to individuals are not allowed to drive out funding for vital community services; and- policies are judged by the quality of care they support and how much they encourage a stable, less gender-divided workforce, as well as value for moneyAny other solution would be unworkable, unfair and inconsistent with government commitments to reduce gender inequalities.Costs will continue to rise as the paid care sector grows, since to recruit and retain care workers, wages will have to keep up with those elsewhere. Because rising care costs are an effect of rising productivity elsewhere in the economy, paying for them will still let disposable incomes increase. Spending more on social care can be afforded.</br