The Sociopolitical Foundations of Health Sector Solidarity: A Cross-Sectional Study of Public Attitudes Toward the Health System in Taiwan.

Publicly-funded health systems have traditionally been presumed to be underpinned by solidarity among the users. To which extent such solidarity presents and associates with what factors is understudied in the non-western countries. This article explores the distribution of health sector solidarity and its relationships with sociopolitical factors in Taiwan.

From bureaucratic administration to effective intervention: Comparing early governmental responses to the COVID-19 virus across East Asian and western health systems.

The outbreak of COVID-19 in early 2020 created dangerous public health conditions which pressured governments and health systems to respond in a rapid and effective manner. However, this type of rapid response required many governments to bypass standing; bureaucratic structures of health sector administration and political governance to quickly take; essential measures against a rapidly evolving public health threat. Each government's particular; configuration of governmental and health system decision-making created specific structural and functional challenges to these necessary centrally developed and coordinated strategies.

An important new health policy voice.

In the 10 years since its founding, the Israel Journal of Health Policy Research has established itself as an important voice in Israeli and international health policy. The Journal's ability to combine national and international perspectives on key issues in health services delivery and health systems analysis has developed a valuable new arena for academic research about the increasingly complex post-COVID future of health care systems.

Can Asia provide models for tax-based European health systems? A comparative study of Singapore and Sweden.

Singapore's health system generates similar levels of health outcomes as does Sweden's but for only 4.4% rather than 11.0% of gross domestic product, with Singapore's resulting health sector savings being re-directed to help fund both long-term care and retirement pensions for its elderly citizens.

Policy Lessons From Early Reactions to the COVID-19 Virus in China.

The World Health Organization (WHO) declared the COVID-19 virus outbreak to be a Public Health Emergency of International Concern on January 30, 2020. Although the Chinese central government implemented significant measures to control the epidemic from January 20 within China, the crisis had already escalated dramatically.Between December 1, 2019, and January 20, 2020, a total of 51 days passed before the Chinese central government took full control.

Strategies for Delivering Value-Based Care: Do Care Management Practices Improve Hospital Performance?

Value-based payment has the potential to rein in the volume incentive inherent in fee-for-service payment by holding providers accountable for the quality of patient care they deliver. Success under the new payment structure will depend on how effectively key organizational reforms are embraced by providers in the implementation of quality improvement processes for care delivery. This study examined the relationship between implementation of care management processes (CMPs, the specific tactics that enable the practice of value-based care) and hospital performance under value-based payment.

Establishing Appropriate Agency Relationships for Providers in China.

Physicians play multiple roles in a health system. They typically serve simultaneously as the agent for patients, for insurers, for their own medical practices, and for the hospital facilities where they practice. Theoretical and empirical results have demonstrated that financial relations among these different stakeholders can affect clinical outcomes as well as the efficiency and quality of care.

Structural effects of the information revolution on tax-funded European health systems and some potential policy responses.

The ongoing information revolution has re-configured the policymaking arena for tax-funded health systems in Europe. A combination of constrained public revenues with rapid technological and clinical change has created a particularly demanding set of operational challenges. Tax-funded health systems face three ongoing struggles: 1) finding badly needed new public revenues despite inadequate GDP growth 2) channeling additional funds into new high-quality provider capacity 3) re-configuring the stasis-tied organizational structure and operations of existing public providers.

The impact of slow economic growth on health sector reform: a cross-national perspective.

This paper assesses recent health sector reform strategies across Europe adopted since the onset of the 2008 financial crisis. It begins with a brief overview of the continued economic pressure on public funding for health care services, particularly in tax-funded Northern European health care systems. While economic growth rates across Europe have risen a bit in the last year, they remain below the level necessary to provide the needed expansion of public health sector revenues.

Re-thinking barriers to organizational change in public hospitals.

Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals.

Uncomfortable realities: the challenge of creating real change in Europe's consolidating hospital sector.

Background: This article examines uncomfortable realities that the European hospital sector currently faces and the potential impact of wide-spread rationalization policies such as (hospital) payment reform and privatization.

Methods: Review of relevant international literature.

Results: Based on the evidence we present, rationalization policies such as (hospital) payment reform and privatization will probably fall short in delivering better quality of care and lower growth in health expenses.

Health reform in Finland: current proposals and unresolved challenges.

The Finnish health care system is widely respected for its pilot role in creating primary-care-led health systems. In the early 1990s, however, a severe economic downturn in Finland reduced public funding and weakened the Finnish system's deeply decentralized model of health care administration. Recent Bank of Finland projections forecasting several decades of slow economic growth, combined with the impact of an aging population, appear to make major reform of the existing public system inevitable.

Governance, Government, and the Search for New Provider Models.

A central problem in designing effective models of provider governance in health systems has been to ensure an appropriate balance between the concerns of public sector and/or government decision-makers, on the one hand, and of non-governmental health services actors in civil society and private life, on the other. In tax-funded European health systems up to the 1980s, the state and other public sector decision-makers played a dominant role over health service provision, typically operating hospitals through national or regional governments on a command-and-control basis. In a number of countries, however, this state role has started to change, with governments first stepping out of direct service provision and now de facto pushed to focus more on steering provider organizations rather than on direct public management.

Health sector solidarity: a core European value but with broadly varying content.

Although the concept of solidarity sits at the center of many European health sector debates, the specific groups eligible for coverage, the financing arrangements, and the range of services and benefits that, together, compose the operational content of solidarity have all changed considerably over time. In prior economic periods, solidarity covered considerably fewer services or groups of the population than it does today. As economic and political circumstances changed, the content of solidarity changed with them.

Challenges facing the United States of America in implementing universal coverage.

In 2010, immediately before the United States of America (USA) implemented key features of the Affordable Care Act (ACA), 18% of its residents younger than 65 years lacked health insurance. In the USA, gaps in health coverage and unhealthy lifestyles contribute to outcomes that often compare unfavourably with those observed in other high-income countries. By March 2014, the ACA had substantially changed health coverage in the USA but most of its main features--health insurance exchanges, Medicaid expansion, development of accountable care organizations and further oversight of insurance companies--remain works in progress.

Structural patterns in Swedish health policy: a 30-year perspective.

This perspective reviews key institutional and organizational patterns in Swedish health care over the last 30 years, probing the roots of several complicated policy questions that concern present-day Swedish decision-makers. It explores in particular the ongoing structural tension between stability, on the one hand, and the necessary levels of innovation and dynamism demanded by the current period of major clinical, technological, economic, social and supranational (EU) change. Where useful, the article compares Swedish developments with those in the other three European Nordic countries as well as other northern European health systems.

United States of America: health system review.

This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world.

Viewing second opinions in terms of recent developments in patient choice.

Patient choice has become an increasingly visible part of publicly funded health care systems. Since the 1990s, many individuals have gained the ability to select their insurer in social health insurance funded systems, while in tax-funded health systems many patients can now select their primary care and hospital providers. Second opinions about clinical procedures are part of this broad movement toward increased patient involvement in care-related decision-making.

The rise of pragmatism in state/market debate.

Discussion about the relative role of public and private in health care has evolved substantially across Europe since the 1980s. The previous, broadly ideological debate about state 'versus' market has been superceded by pragmatic considerations on how best to combine state 'and' market to achieve specific health sector outcomes. The London School of Economics debate about expanded patient choice demonstrated the extent to which pragmatism has gained the upper hand.