Explaining Policy Stability and Change in Swiss Health Care Reforms

The article investigates recent health reforms and reform attempts in Switzerland. A substantial reform, the revision of the health insurance law in 1994, is followed by a long period of refused reform proposals and incremental change. In order to explain policy change and policy stability in health policies, we apply veto‐player theory to partisan and parliamentary debates on reform proposals of the health insurance from the end of the 1980s until today. Shifts in ideological positions of parties, especially with regard to the objective of solidarity, allowed for a new win‐set in the 1990s that was at the base of the law revision. Since then, the win‐set is empty as parties did not change their preferences. New and substantial reforms will only be possible, it is concluded, if the pivot player, the Christian‐democratic party, changes its ideological positions to a significant extent.     

中国公共卫生财政资源分配公平性研究——基于社会剥夺的视角

"社会剥夺"是社会心理学的重要概念体系,本研究旨在基于社会剥夺的视角,对中国公共卫生财政分配的公平性及其公平性缺口进行定量评估.研究发现中国大部分西部和中部地区比多数东部地区具有较高的社会剥夺水平;较高社会剥夺水平的地区,其居民健康需求也较高;中国公共卫生财政资源地区间分布的公平性较差且部分地区公平性缺口较大;但公平性有逐年变好的趋势,这主要归功于政府对人均投入均等化的关注而并非对居民健康需求差异的关注.建议在新一轮医改中,政府应对公共卫生服务的"均等化"准确定位;应逐步建立以需求为导向的平等可及的转移支付机制,重点关注农业人口比重较大的地区,优先支持公平性缺口较大的地区;尽早开发科学有效的财政资源分配工具等.     

Reforming the World Health Organization: what influence do the BRICS wield?

The World Health Organization (WHO) is currently undergoing fundamental reform that is intended to impact its programmes and priority setting and its financial and governing structures. Within the reform debates, new relations of powers are emerging among traditional donors and emerging economies such as the ‘BRICS’: Brazil, Russia, India, China and South Africa. These five emerging economies have formally committed ‘to strengthen and legitimise the WHO as the coordinating authority in global health’ through the principle of multilateralism. In this paper, the results of a qualitative study – based on 21 key informant interviews – that seeks to better understand BRICS’ engagement in this organisation and the extent to which their action enables these countries to influence the reform process were presented. The results show that individual BRICS countries found natural pairings with each other on both particular elements of the reform, notably governance and WHO financing, and specific health issues. While numerous examples of individual BRICS countries seeking to raise the profile of specific health issues were found, some evidence of a coordinated effort to influence reform as a bloc was also found. Although this was largely limited to rhetorical announcements of support in formal Declarations and Communiqués, it nevertheless articulates a vision of the WHO as an organisation with a broad mandate delivered with sufficient, predictable funding.     

传染病控制与国际法

全球化时代控制传染病这一公共健康问题必须进行国际合作才能解决。WTO及其SPS协议在控制通过国际货物贸易传染疾病方面有一些法律机制。国际卫生条例(IHR)是约束WHO成员国防止传染病蔓延的主要国际法律机制。世界卫生组织针对传染病的新形势,对国际卫生条例进行了修改,其修改集中于:(1)扩大各国报告义务范围;(2)加强对非官方信息的依赖;(3)各国出现紧急状态时,WHO采取什么控制方式、建议还是其他;(4)争端解决方式。此外,还有信息、媒体、人权等其他一些法律问题。     

乡村振兴背景下欠发达地区健康治理效能提升研究——以山西促进社会办医参与健康治理为视角

以促进社会办医参与推进健康治理,对我国欠发达地区实现乡村振兴具有重要的实践意义,其逻辑需求蕴含于新时代健康目标、健康返贫风险性及现实新机遇中.基于健康治理分析框架和对山西相关调研,可以发现在促进社会办医参与健康治理中,目前存在影响制约健康治理效能的多重因素,包括经营管理目标理念失当、参与机会空间难以拓展、人才短缺限制自...     

Gender,money and professional identity: medical social work and the coming of the British National Health Service

The arrival of the British National Health Service (NHS) in 1948 heralded significant changes for all health workers, but the establishment of a ‘free’ health service was especially meaningful for the hospital almoners—or medical social workers, as they were starting to be known—who had previously been responsible for the assessment and collection of patient payments. It was on this basis they had gained a foothold in the hospital, capitalising on gendered assumptions of financial understanding and behaviour. Yet what might have caused an identity crisis was embraced. This was a dual strategy of both repositioning the profession in alignment with the planned NHS and of asserting an enhanced professional status by distancing themselves from the handling of payment. It was an episode in the history of this distinctly female profession that speaks to women’s historic relationship with money.     

Regional psychiatric boards in Israel: expectations and realities

As laid down by Israeli legislation, the Regional Psychiatric Board constitutes one of the chief instruments in the monitoring of compulsory hospitalization, of compulsory outpatient treatment and of the quality of all inpatient care of the mentally ill. This article presents the findings of a study into the working of these boards. Taking a sample of every second application (N=168) over a 6-month period to one of Israel's six existing Regional Psychiatric Boards, an examination was made of the decisions issued by the board and of other aspects of its functioning. Explanations for the findings of this analysis are suggested, and generalizing from these findings, recommendations are offered for the improvement of the future functioning of all six Boards.     

徐州市地方卫生立法的回顾与思考

地方卫生立法是国家法制建设的重要组成部分和卫生事业发展的制度保障。笔者通过对徐州市地方卫生立法工作的总结，提出完善地方卫生立法关键是强化地方立法特色、遵循卫生事业发展的规律、规范立法程序。不断提升地方卫生立法工作水平，发挥地方立法的价值，促进卫生事业的健康发展。     

Gender equality needs critical consideration in conflict-affected settings

The World Bank's 2012 World Development Report calls for gender equality on a global level but falls short on its analysis of conflict-affected contexts. It is critical that we understand the needs of vulnerable populations in these settings. This viewpoint draws on findings from research in health reform in conflict-affected contexts to highlight some opportunities and challenges for addressing gender equality in these settings, using the policy priorities outlined in the World Bank report. Drawing on this analysis we argue that more attention and action should be focused on addressing gender inequalities and inequities in neglected conflict-affected states.