Restructuring health services: Changing contexts & comparative perspectives

Health sector "reform" is the euphemism currently used across the world by those promoting the shift to market-let provision of health services. Mixing analysis, evidence and outrage, this book tackles these "reforms" head-on, exploring the consequences of commercial health care for human beings in need, arguing that the public sector is being leached to support private care for the better off;and contesting the new conventional wisdom that, as Imrana Qaadeer puts it, it is somehow no longer possible to create a "responsible and coherent welfare state" in rich and poor countries alike. This is an important book for those wanting to understand what is happening to health services worldwide. This book documents many instances of the poor social, medical and economic outcomes of health care privatisation... and exposes this fashionable ideology for the empty science that it is. Health service delivery is being restructured in both industrialised and developing countries. Public health scholars and policy makers show in this book how this process is accelerating as a result of diverse factors including fiscal pressure, privatisation of infrastructure, and the impending renegotiation of the WTO General Agreement on Trade in Services (GATS). The key policy issues that arise concern the implications of these changes for access and equity in public health provision. This book reviews the rapidly changing context in which financing health care and its relationship to globalization and privatisation are taking place. It examines the specific mechanisms and institutional processes involved. And it explores various contrasting experiences, including HMOs in the USA, Britain's NHS, social health insurances in Western Europe, developing countries, and Cuba.