Consumer-sponsored prepaid group practice: restructuring the health care system

The traditional separation of health care delivery and financing systems is breaking down as various new types of health care facilities are established and as payment continues to be a major concern. Group Health Cooperative of Puget Sound (GHC) was organized as a prepaid group practice system responsive to consumers. Costs, methods of payment and delivery of care are interrelated and are all influenced by consumer ownership. GHC has been refining its benefit programs since 1945. Strategies for controlling use and costs focus on improved provider management and on flexibility. This article explains how the structure of GHC benefits the consumer.     

Confronting Islamist Insurgencies in Africa: The Case of the Islamic State in Mozambique

The proliferation of Salafi-jihadi insurgencies across Africa challenges the United States’ counterterrorism approach. From its inception, the insurgency in Cabo Delgado, Mozambique was driven by local and foreign dynamics, which have been complicated by additional external intervention in the conflict. Using the Cabo Delgado insurgency, we demonstrate how efforts to address its global dimensions, such as the group's affiliation with the Islamic State, can work against attempts to mitigate its local drivers. We conclude with recommendations for a more effective U.S. response that takes both the local and global dynamics into account. This article builds on our February 2021 report “Combating the Islamic State's Spread in Africa: Assessment and Recommendations for Mozambique,” published by the American Enterprise Institute.