James Warner Bjorkman

Health policy reform, national variations and globalization

List of Tables, Figures and Annexes - List of Acronyms - Globalized Concepts and Localized Practice: Convergence and Divergence in National Health Policy Reforms J.W. Bjorkman & C. Altenstetter - Canadian Health Care Reform and the Politics of Decentralization K. Fierlbeck - The Rise of Managed Care in the United States: Lessons for French Health Policy V.G. Rodwin - The French Health Care System: Inconsistent Regulation J. de Kervasdoue, C. Meyer-Meuret, C. Weill & A. Couffinhal-Colburn - Restructuring Health Care Systems in The Netherlands: The Institutional Heritage of Dutch Health Policy Reforms J.W. Bjorkman & K.G.H. Okma - The Reform of the Health Insurance Systems in the Netherlands and Germany: Dutch Gold and German Silver H. Lieverdink & J.H. van der Made - Health Policy-Making in Germany: Stability and Dynamics C. Altenstetter - Health Care Reform in the Federal Republic of Germany: The New and the Old Lander J. Wasem - Institutions and Ideas into Politics: Health Care Reform in Britain and Germany S. Giaimo & P. Manow - The Politics and Economics of Health Care Reform: Britain in Comparative Context C. Paton - Hiding in the Market Place: Technocracy and Politics in Israeli Health Policy D.P. Chinitz - Politics and Foreign Involvement in Reforming the Health Care Systems of Former Socialist Countries G. Zarkovic & W. Satzinger -State, Economy, and Civil Society Interdependency: Lessons from Polish Health Systems D.M. Duffy - Health Care Systems in Transition in Eastern Europe: The Czech Case M. Beckmann & J. Nemec - Implementation of a Single Health System: New Relationships between the Public and Private Sectors in Brazil A.L. Viana, M.S. Queiroz & N. Iba-ez - Global Health Policy Reform: Misleading Mythology or Learning Opportunity? T.R. Marmor - Consolidated References - Notes on Contributors - Name and Organization Index - Subject Index

Accountability in health care: an essay on mechanisms, muddles, and mires.

This paper presents a critical evaluation of several theories of accountability and their applicability to health care concerns. The authors first provide a preliminary refinement of the imprecise concept of accountability itself and then examine four major types (political; bureaucratic; professional; and economic-consumer). Then, by using disciplinary perspectives provided by several schools of thought in political science (legislative supremacy; general manager theory; government by bureaucracy; objective responsibility; citizen participation), they discuss the degree of accountability presently found in various American health policies. After identifying the inherent dilemmmas within any credible accountability approach to health care programs as now utilized in the United States, the authors recommend that all types of accountability be integrated and strengthened by relying more explicitly on practices characteristic of development administration.

Policy, Politics, and Child Health: Four Decades of Federal Initiative and State Response

This paper analyzes the continuity and change in the relationship between federal and state governments in the formation and implementation of child-health programs. After reviewing developments in federal child-health policy since the Sheppard-Towner Act of 1923, methods of implementation and changes in state laws and administrative organization in Vermont and Connecticut are compared with a focus on the major programs authorized by Title V of the Social Security Act. Four broad interactive areas of comparison--governmental relations, program delivery systems, expenditure patterns, and private interests--serve as vantage points for exploring, understanding and explaining the process of policy implementation. Specific conclusions are drawn regarding each area and the overall conclusion is that federal efforts under Title V have not lessened the general neglect of child health in state legislation; nor have they greatly expanded the volume of direct services for child care. They have been sufficiently ambiguous and diffuse to leave the providers dominant, treating diseases and existing conditions rather than focusing energy on preventive measures. Federal resources have been absorbed by expanding administrative overhead, state bureaucracies have been inflated rather than motivated.

Six Countries, Six Reform Models: The Healthcare Reform / Experience of Israel, the Netherlands, New Zealand, Singapore, Switzerland and Taiwan — Healthcare Reforms “Under the Radar Screen”

Usually not given serious consideration in major international comparisons because of their small size, each in fact provides a fascinating case study that illuminates the understanding of the dynamics of healthcare reform. Although dissimilar in historical and cultural backgrounds, they share some important features: all faced very similar pressures for change in the 1970s and 1980s; all considered a very similar range of policy options; and all did not only discuss but actually implemented fundamental changes in their healthcare funding, organization, contracting and governance structures with strikingly different outcomes.