Health care reform
[1] In "Getting Health Reform Right: A Guide to Improving Performance and Equity,"[2] Marc Roberts, William Hsiao, Peter Berman, and Michael Reich of the Harvard T.H.
[2] The authors selected these control knobs as representative of the most important factors upon which a policymaker can act to determine health system outcomes.
[2] These include: The five proposed control knobs represent the mechanisms and processes that policy-makers can use to design effective health care reforms.
These control knobs are not only the most important elements of a healthcare system, but they also represent the aspect that can be deliberately adjusted by reforms to affect change.
The knobs interact with cultural and structural factors that are not illustrated within this framework, but which have an important effect on health care reform in a given context.
Rather than a prescriptive proposal of recommendations, the framework allows users to adapt their analysis and actions based on cultural context and relevance of interventions.
[4] In comparison to the UK, physicians in Germany have more bargaining power through professional organizations (i.e., Medical association); this ability to negotiate affects reform efforts.
The Swiss, on the other hand use more of a privately based health insurance system where citizens are risk-rated by age and sex, among other factors (Belien 90).
Healthcare was reformed in 1948 after the Second World War, broadly along the lines of the 1942 Beveridge Report, with the creation of the National Health Service or NHS.
The NHS[9] for example would distribute baby formula milk fortified with vitamins and minerals in an effort to improve the health of children born in the post war years as well as other supplements such as cod liver oil and malt.
The Conservative Thatcher administrations attempted to bring competition into the NHS by developing a supplier/buyer role between hospitals as suppliers and health authorities as buyers.
The administration committed more money to the NHS raising it to almost the same level of funding as the European average and as a result, there was large expansion and modernisation programme and waiting times improved.
Doctors will give more advice on ill-health prevention (for example encouraging and assisting patients to control their weight, diet, exercise more, cease smoking etc.)
A target was set from December 2008, to ensure that no person waits longer than 18 weeks from the date that a patient is referred to the hospital to the time of the operation or treatment.
[15][16] Following the collapse of the Soviet Union, Russia embarked on a series of reforms intending to deliver better healthcare by compulsory medical insurance with privately owned providers in addition to the state run institutions.
Russia has more physicians, hospitals, and healthcare workers than almost any other country in the world on a per capita basis,[18][19] but since the collapse of the Soviet Union, the health of the Russian population has declined considerably as a result of social, economic, and lifestyle changes.
[24] Employers and the self-employed are legally bound to pay National Health Insurance (NHI) premiums which are similar to social security contributions in other countries.
