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At least 19 recordsLinked to original sources
PubMed1979

The development of early Chinese Communist health policy: health care in the Border Region, 1936-1949.

This paper examines the health care policy and program of the Chinese Communists in their earliest stages of development. An assessment of 1) political policy, 2) public health campaigns, 3) medical services, 4) public health education, and 5) medical education, indicates that the role of the health delivery scheme was primarily to mobilize mass support for the government, and to change popular health behavior, thereby improving the health of the people and lessening demand on scarce medical facilities. An analysis of the Border Region's health program from 1936 to 1949 gives us an insight into the strategy of a revolutionary government to win popular support and to effect social change.

China↗
PubMed1976

Health services research and health policy.

Health services research (HSR) has the potential to influence the decision-making process in a health services system that is acutelearchers feel, with some truth, that their research has had only a limited effect on health policy. Some reasons for this are described, including the primacy of political, rather than technical, considerations in policy making, the lack of a comprehensive health policy, and the poor quality and irrelevance of much HSR. The role of funding for HSR by the Federal government is described; it is shown that the Federal effort is fragmented, despite the consolidation efforts made in 1968. Increased support for specific targeted, problem-solving health services research is proposed, and some possible methods to achieve this are described.

Financing, Government↗
PubMed1976

Medical politics, health policy. Party health platforms, promise and performance.

Health policy in the United States is a product of medical politics. "Medical politics" includes not only traditional patterns of interest group pressures but traditional political party philosophies and patient expectations as well. Characteristic Republican politics reflects narrower governmental spending and greater emphasis on support of entrepreneurial effort. Desired effects will "trickle down" to the needy. Democratic politics tend to follow a more generous spending line, not neglecting the entrepreneurs, but spreading some of the funds around to the needy themselves. In addition, Republicans tend to distrust salaried officials, placing governmental power (through government funds) into the hands of private agencies or companies. Democrats hesitate less to build bureaucratic structures. On the record, both parties follow roughly similar lines in spite of these philosophic differences, which turn out to be differences in style. Both parties have practiced restraint in financing of medical services, only recently undertaking payment for these, and only recently undertaking to pay for medical education. Research has been a favored federal focus. Rapid and seemingly uncontrollable inflation has forced both parties to take a harder line. Political platforms are not necessarily clear signals of eventual party action. Nevertheless, they underline what the parties consider to be the problems as the voters see them and they express what the parties see as the appropriate response to these problems. This paper suggests what the party platforms will look like for the presidential election this year and also what the parties will probably do thereafter.

Aged↗
PubMed1978

Consumer attitudes toward health policy and knowledge about health legislation.

Consumer attitudes toward key issues affecting health policy decisions in the local community have been ignored both by local health policy makers and by medical sociologists. The authors report an empirical analysis of: (1) consumer attitudes towards federal intervention in health care; (2) consumer perceptions of the free market philosophy of health providers; (3) consumer perceptions of their involvement in health policy making; (4) consumer confidence in present systems of health services delivery; and (5) consumer awareness of recent major health legislation. It was found that consumers are poorly informed about recent health care legislation. The authors compared the attitudes of consumers with those held by local hospital board members toward health policy issues. The differences for all comparisons were statistically significant. The authors argue that hospital board members attribute problems in health services delivery to demand dysfunctions while consumers perceive the problems to be a result of supply dysfunctions. Thus, failure to include consumers on health policy boards guarantees the absence of a solution-oriented dialogue and promotes the continuing predominance of a provider-biased ideology.

Attitude to Health↗
PubMed1992

Epidemiology and Health for All. The role of epidemiology in a health policy.

World Health Organization's goal Health for All is the starting point for a most ambitious health policy ever. The paper analyzes the role of epidemiology in the Organization's work, particularly in the Health for All development. During WHO's early years, epidemiology helped to design and carry out major public health campaigns against such scourges of the humanity as yaws, tuberculosis, malaria and small pox. When the Organization during the 1960s began to emphasize the need to develop the infrastructure of health care, health services research partly replaced epidemiology as WHO's main scientific allay. After the Health for All policy was launched in 1987, epidemiology has again played a major role in establishing the scientific background of the policy. The European experiences show how the epidemiologists can help WHO to identify the most important health problems and set achievable and measurable targets for them. The paper concludes that epidemiology serves to identify problems, show ways to solve them, monitor the changes in the situation and evaluate the achievements.

Epidemiology↗
PubMed1992

The organic dimensions of health policy.

The health care system is a level of the larger social system, within which it must seek and find its equilibrium. This organic concept leads to a more realistic assessment of needs and goals, and can make a significant contribution in helping reshape national health policy. It also suggests a re-examination of a two-tiered approach to health benefits: a universally available level of care deemed essential for meeting social needs, and an optional coverage level directed toward meeting those individual life goals which may exceed social needs.

Delivery of Health Care↗
PubMed1979

Public choice in health: problems, politics and perspectives on formulating national health policy.

Development of health policy goals necessitates a choice among normative premises--an accommodation of conflicting values. Any debate that does not identify underlying assumptions or link policy prescriptions to a theoretical perspective is destined to degenerate into uncommunicative and unproductive rhetorical posturing. A sensible approach toward formulating national health policy requires that competing values be identified and discussed explicitly. This article will examine the effect that selection of different theoretical perspectives can have on the identification of problems and on the formulation of prescriptive policies in the health field. It will also focus on the different values that are promoted by different policy perspectives and consider alternative models for implementing value choices.

Attitude to Health↗
PubMed1991

Analysis of health policy--principles and practice.

Health policy analysis covers a wide range of activities: from university-based research to practical activities carried out by bureaucrats and professionals working within the health system with independent unit or think tanks for health policy analysis as a third alternative. A key distinction is between analysis of policy and analysis for policy, which has eight key features: problem-centered; bias to facts and data; multidisciplinary; emphasis on feasibility; uses techniques and political awareness; quantitative and qualitative analysis; role of values; and timing of analysis. Decision-making is not a rational, logical process in which information and research determine policy outcomes, but a highly political process in which power and interest are the main driving forces. Health policy analyses can make a small contribution. Communication and salesmanship must go hand in hand with good academic techniques if research is to influence policy.

Bias↗
PubMed1992

Teaching health policy and politics in U.S. schools of public health.

Because most public health endeavors in the United States are funded by the public sector, public health practitioners need to be adept at working within the political system. However, the 1988 Institute of Medicine report, The Future of Public Health, found that many public health professionals are ignorant or disdainful of political processes and will not participate in activities that they perceive to be political. Our study examined the health policy and politics curricula of the 24 accredited schools of public health in the U.S., finding that most public health students are not exposed to these areas during their graduate coursework. Moreover, those students who do take health policy and politics courses study these areas within the context of health care delivery; the politics of public health and prevention are ignored by most schools of public health. Recommendations for improving public health curricula in health policy and politics are presented, including linkages with prevention activities.

Curriculum↗
PubMed1992

U.S. mental health policy. Doomed to fail.

Changes in the de facto system of mental health care in the last decade reflect organizational and entrepreneurial responsiveness to changes in health policy, not mental health policy. Various other actions described here reduced statutory or institutional leadership roles in mental health and increased the pace at which mental health policy was becoming dependent on health policy. In turn, U.S. health policy in the 20th century has been inherently flawed. The short-term general hospital--the "doctors' workshop"--emphasizing acute care and surgery, has been the cornerstone of U.S. health policy throughout the 20th century. The mimicry of health services by mental health leads to demonstrably more expensive and less effective mental health care and dooms mental health policy to failure.

Community Mental Health Centers↗
PubMedDate not supplied

Social surveys and health policy implications for national health insurance.

The authors explore the utility of applying social survey data (a) to evaluate the impact of existing health programs and (b) to rank-order priorities concerning future health care policies. Based on national survey data from 1963, 1970, and 1976, they concluded that although Medicare and Medicaid have enabled more people to see a physician than ever before, a large proportion of the population still registers dissatisfaction with the health care they received--particularly with respect to their out-of-pocket costs for obtaining it. However, national health insurance options favored by the majority of the population--particularly those who can best afford the cost of care--suggest preferences for programs that incorporate some mix of existing modes of financing rather than those that provide for substantial restructuring of the current system.

Attitude to Health↗
PubMed1992

More lessons, of a different kind: Canadian mental health policy in comparative perspective.

Many health policy reformers and researchers in the United States have focused on the Canadian health care system and its lessons for design of a national health care program in the U.S. Yet minimal attention has been given to Canadian mental health policy in this discussion. The author reviews the historical development of mental health services in Canada and discusses five current sources of tension in Canada's mental health care system, many of which are familiar to the American setting: restriction on fee-for-service payments, a two-tiered pattern of care involving provincial mental hospitals and general hospital psychiatric units, shortages of mental health care resources, limited funding of community-based programs, and lack of coordination of care. The author concludes that universal insurance coverage patterned after the Canadian model would ameliorate only some problems faced by mentally ill persons in the United States. Mental health benefits must be structured to ensure the availability and organization of a full spectrum of long-term health care and supportive services.

Canada↗