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This article explores the political and economic forces involved in the development of privatization policies within the health care sector in Thailand. It is suggested that many of the motivating factors behind private sector growth are outside of the health sector; the general macroeconomic environment and tax incentives have stimulated private sector expansion. Within the Ministry of Public Health a preoccupation with improving care in rural areas and an unclear policy line on the private sector has facilitated this expansion. Only recently has private sector growth come to the policy agenda. During this lag period a number of interest groups have developed. It will be difficult to overcome these entrenched interests in order to change policy direction. Meanwhile, problems of rapid cost inflation and inequity face the Thai health care system. Although this case study focuses upon the health care sector in Thailand it would appear relevant both to other sectors and to other countries. The relationship between development models based upon pro-private, pro-market tenets and the establishment of a satisfactory social policy is questioned. 相似文献
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Rosenbaum S 《Journal of health politics, policy and law》2006,31(3):657-670
Despite the size of their report, the Federal Trade Commission and Department of Justice pay virtually no attention to tens of millions of uninsured and underinsured persons. By focusing on an increasingly rarified group of health care customers--healthy, affluent, and highly insured--the report takes on an untethered quality, with only the slightest tip of the hat to its own limitations. Furthermore, the report overstates the extent of legal constraints on the market, in particular, the degree to which the market is free to select its customers and tailor its goods and services to the best risks. By miscasting the legal context of the American health care system, the report ultimately undermines much of its potential value. 相似文献
125.
Introducing a new medical technique, procedure or drug to the public via clinical trials is risky at the best of times. When the trial involves a biotechnology which holds out the promise of prolonging, if not saving, life the push to move from the laboratory to clinical trials may be hard to resist. In this article I explore whether the regulatory scheme for clinical trials in the UK is able to accommodate developing technologies by considering how the current legal and ethical frameworks determine when a procedure such as xenotransplantation should proceed to trials. In particular, I discuss whether basing our regulatory schemes on the principles espoused in the Declaration of Helsinki offer sufficient protection to those who may be affected by xenotransplant trials – the recipient, their health-care workers, close contacts and, unusually, the wider public. I question whether it is possible for a technology to be approved for clinical trials when allowing such trials may benefit the individual but ultimately negatively impact on society as a whole. 相似文献
126.
Shmuel Shulman Steven Carlton-Ford Rivka Levian Sara Hed 《Journal of youth and adolescence》1995,24(3):281-294
The study compares coping styles of 50 learning disabled and nonlearning dis-abled adolescents and their parents. Analyses indicate that learning disabled adolescents show less ability to appraise a source of stress and seek information in the various domains with which they are expected to cope. Also, they reveal a higher level of pessimism about problems in academic-related domains. Coping patterns of parents of learning disabled adolescents do not show clear differences from parents of nonlearning disabled. Yet mothers of learning disabled adolescents tend more to seek and accept help. Learning disabled adolescents' coping is clearly related to coping or more specifically to difficulties in coping of their parents. Results are discussed in the context of the special difficulties of the learning disabled during adolescence and the role their parents play during this developmental stage.Received Ph. D. from Bar Ilan University. Research interests include developmental and family processes in normal and pathological adolescents.Received Ph.D. from University of Minnesota. Main interests are developmental and family processes in adolescence.Received M.A. in counseling from Tel Aviv University.Received M.A. in counseling from Tel Aviv University. 相似文献
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Using case-study material of contracting for clinical and ancillary services in the health care sector of developing countries, this article examines the capacities required for successful contracting and the main constraints which developing country governments face in developing and implementing contractual arrangements. Required capacities differ according to the type of service being contracted and the nature of the contractor. Contracting for clinical as opposed to ancillary services poses considerably greater challenges in terms of the information required for monitoring and contract design. Yet, in some of the case-studies examined, problems arose owing to government's limited capacity to perform even very basic functions such as paying contractors in a timely manner and keeping records of contracts negotiated. The external environment within which contracting takes place is also critical; in particular, the case-studies indicate that contracts embedded in slow-moving, rule-ridden bureaucracies will face substantial constraints to successful implementation. The article suggests that governments need to assess required capacities on a service-by-service basis. For any successful contracting, basic administrative systems must be functioning. In addition, there should be development of guidelines for contracting, clear lines of communication between all agents involved in the contracting process, and regular evaluations of contractual arrangements. Finally, in cases where government has weak capacity, direct service provision may be a lower-risk delivery strategy. © 1998 John Wiley & Sons, Ltd. 相似文献
129.
Sara L. Friedman 《Citizenship Studies》2010,14(2):167-183
As Taiwan transitions from an immigrant-sending to an immigrant-receiving country, it struggles to build an immigration bureaucracy while its status as a sovereign nation-state is not recognized by much of the international community. Taiwan's largest immigrant group, marital migrants from China, are perceived as posing the greatest challenges to border control due to longstanding political tensions between the two countries and governmental and societal suspicions about Chinese spouses' marital motives. Based on research conducted with immigration officials and during immigration interviews at the border, this article interrogates the status of ‘truth’ in official efforts to determine definitively immigrants' marital intentions. It analyzes such truth demands in relation to Taiwan's anxieties about its national standing and the ability of an immigration bureaucracy to generate ‘sovereignty effects’. 相似文献
130.
Peter Lloyd-Sherlock Rosie Mayston Alberto Acosta Sara Gallardo Mariella Guerra Ana Luisa Sosa 《发展研究杂志》2018,54(4):682-701
This paper applies different analytical frameworks to explore processes of family bargaining about providing care for dependent older people in Mexico and Peru. These frameworks include cultural norms, life course effects and material exchange. The paper is based on 19 in-depth qualitative family case studies, which are linked to a wider set of quantitative survey data. Care arrangements and bargaining processes are revealed to be highly gendered, and largely conform to prevailing cultural norms. Rather than neutral and objective, the self-identified role as main carer is found to be subjective and potentially ambiguous. The few men who self-identify as main carers are more likely to play an indirect, organisational role than engage directly in daily care. As such, bargaining mainly relates to which woman performs the main care role, and large family networks mean that there is usually more than one candidate carer. Bargaining can occur inter-generationally and conjugally, but bargaining between siblings is of particular importance. Bargaining is framed by the uncertain trajectory of older people’s care needs, and arrangements are sometimes reconfigured in response to changing care needs or family circumstances. Taking the narratives at face value, the influence of life course effects on bargaining and care arrangements is more obvious than material exchange. There are, however, indications that economic considerations, particularly inheritance, still play an important behind the scenes role. 相似文献