Reforming Health Sector Reform

Abstract

The 1990's have seen a fundamental questioning of the nature, form and content of health systems. Evidence has accumulated that in terms of efficiency and equity, no country can be satisfied with the performance of its health system. Concerns include: the extent to which health systems are responsive to health needs as opposed to professional preferences; the need to ration access to care and how best to do it; how to make services more responsive to users; and how to ensure that the needs of the poorest and most disadvantaged are met. Countries across the world whether rich or poor, are attempting to change how health systems are financed organised, and managed. Proposed reforms are often radical; progress in implementing reforms is often slow; consensus is notably absent. These papers by leading academics and practitioners shed light on reform ideologies, strategies, and experiences. Foreword / David Nabarro -- Reforming health sectors: fashions, passions and common sense / Anne Mills -- Health for all or wealth for some? Conflicting goals in health care reform / Robert G. Evans -- Changing the role of the state / Julio Frenk -- Reforming state capacity: the demands of health sector reform in developing countries / Sara Bennett -- Readdressing equity: the importance of ethical processes / Lucy Gilson -- Global health policy reform: misleading mythology or learning opportunity? / Theodore R. Marmor -- Reforms to financing systems in poor countries / Barbara McPake -- Managed care, risk sharing and health system reforms in the United States / Richard Scheffler -- Reforming integrated systems. The case of the UK: a balance sheet of the evidence on the impact of the internal market / Nicholas Mays -- Reforming pluralist systems: the case of Colombia / Francisco Jose Yepes and Luz Helena Sanchez -- Private finance in public facilities-the experience of the UK / Allyson Pollock and Declan Gaffney -- Designing and implementing successful health reforms: the role of research and research institutions / Somsak Chunharas and David Harrison -- Implementing successful health care reforms: minding the process / Josep Figueras, Richard B. Saltman, Tom Rathwell and Gill Walt -- Rethinking health sector reform: personal reflections / Anne Mills.