This book addresses the global need for more comparative studies on health policy and health care systems, given the rise in recent decades of societal aging, modern mass diseases, economic globalization, and resulting permanent fiscal austerity of governments which have fundamentally altered the status quo of health care systems. The book examines the healthcare experiences of the most developed countries in Asia (Japan, South Korea, Taiwan and Singapore) and compares these with four of the most important health care systems in Europe (UK, France, Germany and Italy). Focusing on the public health care systems the contributors discuss the rising need for reforms in health care and health insurance administration, delivery systems, financing and overall health care policy strategies, particularly in fast-aging societies in Asia, and highly aged societies in Europe. This book will appeal to students and scholars of health care policy, health and social administration, social policy, public policy and social work. It will also provide a reference for professionals who need a view of the trajectory of public health financing in relation to changed and changing demographics and disease patterns.

Informal payments in the health sector of Eastern and Central Asia are emerging as a fundamental aspect of health care financing and a serious impediment to health care reform. These informal payments, made to individuals or institutions in cash or in kind, are nearly always for services that are meant to be covered by the health care system. Such private payments to public personnel have created an informal market for health care , and are a form of corruption. This problem's roots are traced to declining revenues which have not coincided with a reduction in buildings, hospital beds and health personnel. In these circumstances informal payments compensate for lost earnings, and therefore reforms to modernise the region's health systems must compete with individuals' personal revenues. Options for addressing this problem include comprehensive anticorruption policies, downsizing of the public health system, reducing the set of services sibsidised by the state, encouraging cost sharing with those who can afford it, improving accountability, and promoting private alternatives.

Fifty years ago, health outcomes in the countries of Eastern Europe and Central Asia were not far behind those in Western Europe and well ahead of most other regions of the world. But progress since then has been slow. While life expectancy in the ECA region today is close to the global average, the gap with its western neighbors has doubled, and other middle-income regions have all surpassed ECA. Some countries in the region are doing better, but full convergence with the world’s most advanced health systems is still a long way off. At the same time, survey evidence suggests that the health sector is the top priority for additional investment among populations across the region. The experience of high-income countries also suggests that popular demand for strong and accessible health systems will only grow over time. Yet these aspirations must be reconciled with current fiscal realities. In brief, health sector issues are a challenge here to stay for policy-makers across the ECA region. This report draws on new evidence to explore the development challenge facing health sectors in ECA, and highlights three key agendas to help policy-makers seeking to achieve more rapid convergence with the world’s best performing health systems. The first is the health agenda, where the task is to strengthen public health and primary care interventions to help launch the “cardiovascular revolution” that has taken place in the West in recent decades. The second is the financing agenda, in which growing demand for medical care must be satisfied without imposing undue burden on households or government budgets. The third agenda relates to broader institutional arrangements. Here there are some key reform ingredients common to most advanced health systems that are still missing in many ECA countries. A common theme in each of these three agendas is the emphasis on improving outcomes, or “Getting Better”.

People have always travelled within Europe for work and leisure, although never before with the current intensity. Now, however, they are travelling for many other reasons, including the quest for key services such as health care. Whatever the reason for travelling, one question they ask is "If I fall ill, will the health care I receive be of a high standard?" This book examines, for the first time, the systems that have been put in place in all of the European Union's 27 Member States. The picture it paints is mixed. Some have well developed systems, setting standards based on the best available evidence, monitoring the care provided, and taking action where it falls short. Others need to overcome significant obstacles.

This concise reference provides a one-stop point of research that examines major aspects of health care systems for over 190 countries worldwide. In a consistent format, ten major health care categories are systematically examined for each country: 1. Emergency Health Services; 2. Costs of Hospitalization; 3. Costs of Drugs; 4. Major Health Issues; 5. Government Role in Health Care; 6. Insurance; 7. Access to Health Care; 8. Health Care Facilities; 9. Health Care Personnel (doctor level of training, etc.); and 10. Public Health Programs. The volume is organized in alphabetical order of country names. Each country is presented on a two- or three-page spread with the same descriptive and statistical content, allowing readers to compare health care systems from country to country. For example, a reader may compare costs of drugs in France versus the United States versus Canada. Each country spread will feature short entries on the ten health care categories accompanied by charts, table, and photos as appropriate. The work culminates as a unique and essential resource for pre-med and medical students, as well as researchers in sociology, economics, and the health management fields.

While there may be consensus on the broader issues of the core objectives of the health care system, expectations differ between EU countries, and European national policy-makers. This book seeks firstly to assess the impact of the enlargement process and then to analyse the challenges that lie ahead in the field of health and health policy.

* What roles do hospitals play in the health care system and how are these roles changing? * If hospitals are to optimize health gains and respond to public expectations, how should they be configured, managed, and sustained? * What lessons emerge from experiences of changing hospital systems across Europe? Hospitals of the future will confront difficult challenges: new patterns of disease, rapidly evolving medical technologies, ageing populations, and continuing budget constraints. This book explores the competing pressures facing policymakers across Europe as they struggle to respond to these complex challenges. It argues that hospitals, as part of a larger health system, should focus on enhancing health outcomes while also responding to public expectations. Adopting a cross-national, cross-disciplinary perspective, the study assesses recent evidence on the factors driving hospital reform and the strategies used to improve organizational performance. It reviews the evidence from eastern as well as western Europe and combines academic research with real-world policy experience. It looks at the role of hospitals in enhancing health rather than simply processing patients. The book concludes that hospitals cannot be managed in isolation from society and the wider health system, and that policymakers have a responsibility to define the broader health care goals that hospitals should strive to meet. Hospitals in a Changing Europe synthesizes current evidence in a readable and accessible form for all practitioners, policy-makers, academics and graduate level students concerned with health reform.

Decentralization has become a popular management strategy in many European health care systems. The term describes a wide variety of power transfer arrangements and accountability systems. The logic of decentralization is grounded in an intrinsically powerful idea; that smaller organizations, properly structured and steered, are inherently more agile and accountable than larger organizations. In a world where large organizations control wide swathes of both public and private sector activity, the possibility of establishing more locally operated, locally responsible institutions holds out great attraction. This text explores the capacity and impact of decentralization within European health care systems. It examines both the theoretical underpinnings as well as recent practical experiences, drawing upon both published literature and evidence collected directly from the field. The book also assesses the appropriateness of management processes within health systems for implementing a successful decentralization strategy. Decentralization in Health Care will appeal to health policy makers, postgraduates taking courses in health services management, HR, health policy and health economics, and human resource professionals.

"Today Singapore ranks sixth in the world in healthcare outcomes well ahead of many developed countries, including the United States. The results are all the more significant as Singapore spends less on healthcare than any other high-income country, both as measured by fraction of the Gross Domestic Product spent on health and by costs per person. Singapore achieves these results at less than one-fourth the cost of healthcare in the United States and about half that of Western European countries. Government leaders, presidents and prime ministers, finance ministers and ministers of health, policymakers in congress and parliament, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think-tanks should know how this system works to achieve affordable excellence."--Publisher's website.

Central Asia remains one of the least known parts of the former Soviet Union. The five central Asian republics gained their unexpected independence in 1991. They have faced enormous challenges over the last decade in reforming their health care systems, including adverse macro-economic conditions and political instability. To varying extents, each country is diverging from a hierarchical and unsustainable Soviet model health care system. Common strategies have involved devolving the ownership of health services, seeking sources of revenue additional to shrinking state taxes, 'down-sizing' their excessive hospital systems, introducing general practitioners into primary care services, and enhancing the training of health professionals. This book draws on a decade of experience of what has worked and what has not. It is an invaluable source for those working in the region and for others interested in the experiences of countries in political and economic transition.