First, is the question of deciding - or not explicitly deciding - what proportion of GNP should be devoted to health and welfare. Second, is the problem of agreeing on appropriate criteria to allocate health and social service expenditures. Third, is the problem of how to implement established policies: through regulation, promotion of competition, budgeting, or reimbursement incentives directed at health care providers. The readings, lectures and class discussions will focus on the organization and financing of health systems in wealthy nations.
We begin with a discussion of conventional health system models around the world and alternative perspectives for studying them and evaluating their performance. We will discuss how so much of the literature draws on selective evidence to evaluate health care systems in the U. Finally, we will study a range of different approaches to the empirical analysis of health system performance in selected nations, and examine the extent to which the available evidence supports or refutes widely shared views of different health care systems.
All health systems, in the industrialized world, grapple with problems of cost, access, equity and quality of health care; and the trade-offs among these objectives. Reforms based on promoting markets, managed competition, public contracting, improved management, and changing financial incentives are some important issues under discussion in most nations. This seminar relies on public policy analysis and political economy perspectives to compare health systems in wealthy nations and analyze efforts at health care system reform. The readings, lectures, and class discussions will make students more knowledgeable about policy options and policy changes in different countries.
I will also provide opportunities for students to pursue their individual research interests by comparing two relatively wealthy nations of their choice. The seminar begins with an introduction to health care system performance. Next, we focus on theories, concepts and fads in health care reform, including managed competition, primary health care reform, and universal health coverage. We then examine the politics of health system reform efforts in selected nations — France, Canada, the United Kingdom and China.
Why are people in some countries so much healthier than others?
Why are health systems around the world organized and financed in such different ways? What difference do health systems and universal health coverage UHC make in explaining differences in population health? We begin by considering the challenges for HPAM and why the field should be concerned with global cities, the spread of infectious disease and the design of public health infrastructure.
We will then turn our attention to the roles of state and non-state actors in global policies aimed to improve health care systems and population health. Finally, we consider the meanings of universal health coverage UHC and how the globalization of the medical industrial complex is likely to affect the future of health care systems. All nations face challenges from the effects of globalization and international organizations e. Government leaders must address not only health problems within their borders, but those that cross their borders.
Likewise, they must interact with international organizations that affect global health. The course draws on diverse disciplinary and professional perspectives public health, economics, political science, management, sociology, anthropology. It has two objectives: to expose students to the burgeoning literature in global HPAM; and to prepare them to work in international organizations, consulting firms, and governments.
Documents de travail
Cottenet J. Quantin C. Journal of Comparative Policy Analysis. Comparative Health Systems. Gusmano, VG. Rodwin, D. Health Affairs; 37 10 : Commentary on Laugesen. Gusmano, E. Strumpf, J. Fiset-Laniel, D.
Weisz, VG. Comparative analysis of health system performance in Montreal and New York: the importance of context for interpreting indicators. Health Economics, Policy and Law. The French Health Care System. Rodwin, G.
Inside the magazine
Fabre, RF. Yilmaz, A. Roussot, V. Rodwin, M. Gadreau, A. Bernard, C. Creuzot-Garcher, C. Did case-based payment influence surgical readmission rates in France? A retrospective study. BMJ Open, 8 2 , pp. Zabawa, J.
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Public Health; Weisz, and R. Weisz, J. Cottenet, and C. A comparative analysis of hospital readmissions in France and the US. International Journal of Health Policy and Management. Obamacare, five years after the law French. Chinitz and VG. Laborde, and VG. Report on avoidable hospitalizations in the Greater Paris Region French.
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Chinitz, VG. In Knickman and Kovner eds. Health Care Delivery in the United States,.
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