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Accountability for NGOs INTERNATIONAL HEALTH SYSTEMS HEALTH SYSTEMS FEATURES Personal and public health service provision Healthcare workforce Access to essential medications and...

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Accountability for NGOs
INTERNATIONAL HEALTH SYSTEMS
HEALTH SYSTEMS FEATURES
Personal and public health service provision
Healthcare workforce
Access to essential medications and technologies
Health information system
Health financing system
Oversight
Adapted from
Birn A-E, Pillay Y, Holtz TH. Textbook
of International Health. New Yo
k: Oxford University Press; 2009.
    CATEGORIZATION OF APPROACHES TO SELECTED HEALTH SYSTEM            
        National Health Insurance    National Health Service    Pluralistic
    Health as a Right    Fundamental    Fundamental    Health as a personal good
    Ownership of facilities    Vast majority public and private, not-for-profit    Overwhelmingly public    Public, Private, for-profit and private, not-for-profit
    Employment of Providers    Largely private    The health service and private    Largely private
    Form of Insurance    Largely government single payers and firms working with governmental schemes    Overwhelmingly public insurance linked to the health service    Public insurance and private, for-profit and private, not- for-profit with substantial numbers lacking insurance
    Financing of Insurance    Some based on individual premiums, others based on employee and employer payroll taxes, some are tax based    Overwhelmingly tax- based    Taxes, employer and employee insurance contributions, individual purchase out of insurance and out-of-pocket
    Country Examples    France, Canada, Japan, Germany    United Kingdom    India, Nigeria, Philippines, USA
Challenge of health policy making in the 21st century
Healthcare is one part of the society that is always under some degree of scrutiny and regulations – thereby affecting health policy directly or indirectly.
Medicine within social organizations
Policy-making challenges
Analysis of micro and macro models
4
MICRO AND MACRO MODELS
The political process
In the most fundamental way, health policy making is a political process.
Most policy making usually involves governmental and NGOs and individuals.
Micro and macro frameworks
Analogous to economics
Health policy making can be usefully described using both micro and macro framework, just like in economics.
5
MICRO POLICY MAKING
Characteristics of the policy marketplace model









Assumption
Marketplace assumes that individuals and groups are constantly interacting to satisfy their needs
Policy actors
All policy actors are both suppliers and demanders because they must exchange some commodity in the marketplace to purchase the other goods that they want.
Disparities in powe
Just like in economics, individuals and groups that can supply more can demand more in exchange.
Cu
ency used
The cu
ency used in exchanges can be money, but it can include superior leadership, more effective organization, access to and greater articulation through communications media and greater group member willingness to exert great efforts in order to advance the interests of the group.
Impact of governmental regulation
To gain control over their relevant areas of the marketplace, NGOs will attempt to forge enduring alliances with governmental agencies.
6
Macro Policy Making
- The policy systems model
Complexity
Inte
elatedness
Cyclical processes
7
MACRO POLICY MAKING
– THE POLICY SYSTEMS MODEL
Longest’s model of health policy development
Recognition of inputs
Policy formation
Policy outputs
Implementation
Outcomes
Feedback & subsequent modifications
8
CONVERGENCE OF PROBLEMS AND RESPONSES
9
Cost containment
Access to care
Disadvantaged subpopulations
Informal payments (
ibes; co
uption)
Political instability
Impact of new technologies
Cost and complexity
Balance between old and new
Economic and ethical conflict
CONVERGENCE OF PROBLEMS AND RESPONSES
Quality of care considerations
Technologic complexity
Enable the aggregation of data
New information technology
Measuring health outcomes
Potential benefit of health IT
Consensus about existing problems
US system expensive, wasteful, unsustainable
10
CONVERGENCE OF PROBLEMS AND RESPONSES
Sustainability
Growing financial stress on public and private sectors
Achieving sustainability
Quest for common ground
Digital backbone
Incentive realignment
Quality and safety standardization
Resource deployment
Innovation
Adaptability
11
NATURE OF TRADEOFFS, IDEOLOGY, AND ETHICS
Tradeoffs
Source
Importance
Economic efficiency and political equity
Prioritizing efficiency and equity
12
NATURE OF TRADEOFFS, IDEOLOGY, AND ETHICS
Tradeoffs
Political obstacles
Expectations of the populace
Ethical and ideological disagreements
Social experimentation without public consultation
Undeveloped “rule of law”
13
NATURE OF TRADEOFFS, IDEOLOGY, AND ETHICS
14
Tradeoffs
Components of justice
Justice has both individual and social component. Ethical health policy making implies an acceptance of
individual autonomy
In health policy making, the social component is reflected primarily in the debate over distributive justice or the fairness in the distribution of health benefits and burden in society. Egalitarian view of justice where equal access to health services for all citizens, regardless of income or class is of central importance.
Libertarian perspective
There is also a libertarian perspective of fairness that would argue against Egalitarianism.
POLICY-MAKING AROUND THE WORLD
Assessment of ability address challenges
Assessment of sustainability of US system
No reform will lead to de facto rationing
Reform faces significant political problems
Something major will occur in the next one or two decades
15
POLICY-MAKING AROUND THE WORLD
Equating national health service with rationing
Situation in developing countries
Political instability
Social inequality
Immature economies
16
OVERALL HEALTH SYSTEM PERFORMANCE RANKING, SELECTED COUNTRIES
Data from WHO. The World Health Report 2000, Annex Table 1. Geneva. 2000.
    COUNTRY    Performance Ranking
    Afghanistan    173
    Argentina    75
    Bangladesh    88
    Bolivia    126
    Canada    30
    China    144
    Costa Rica    36
    Cuba    39
    Denmark    34
    Dominican Republic    51
    Egypt    63
    France    1
    Germany    25
    Ghana    135
    COUNTRY    Performance Ranking
    Haiti    138
    India    112
    Jordan    83
    Mexico    61
    Morocco    29
    Nepal    150
    Pakistan    122
    Philippines    60
    South Africa    175
    Sri Lanka    76
    Turkey    70
    United States of America    37
    Vietnam    160
    Zambia    182
ECONOMICS OF HEALTH SYSTEMS
Health services and payment models
Most high-income countries have a government-sponsored healthcare system
The U.S. has a (mostly) privately-sponsored healthcare system (except for Medicare, etc.)
Low-income countries have a mix of public and private providers that require out-of- pocket payment at the time of service
Public and Private approaches to healthcare funding and coverage
PERSONAL HEALTHCARE COSTS
High-income countries spend more than low-income countries on health care
Low-income countries generally require the highest financial contributions from patients (both as a % of healthcare costs and as a % of household income)
Total expenditure on health per capita in U.S. $ in 2009
Source: Kaiser Family Foundation
Health Consumption Expenditures per Capita, US Dollars, 2017
Source: Kaiser Family Foundation
Health Consumption Expenditures as Percent of GDP, XXXXXXXXXX
Expenditure on health by governmental and private sources in 2009
PAYING FOR PUBLIC HEALTH
Global public health is funded by a variety of contributors
Global health funding is about more than the global rich aiding the global poo
Global health funding aims to address shared health concerns and achieve mutual goals
GOVERNMENT FUNDS
The majority of public health initiatives around the world are funded by the governments providing those services
Sources of funding for the health system in 2010
BILATERAL AID
Bilateral aid:    money given directly from one country to anothe
Major donor nations (>$10 billion each in 2010): United States, United Kingdom, France, Germany, Japan
Major donor nations as % GNI (>0.8%): Norway, Luxembourg, Sweden, Denmark, Netherlands, United States: <0.2% GNI
THE WORLD BANK & IMF
Multilateral aid:    money pooled from many donors and given as loans that have to be repaid or as grants (gifts)
World Bank: makes loans to developing countries, usually for infrastructure projects
IMF (International Monetary Fund): makes loans to any country that could not otherwise pay the interest on their other loans
Heavily Indebted Poor Countries (HIPC) Initiative aims to forgive some loans
PRIVATE FOUNDATIONS
Private foundations are making an increasingly significant contribution to spending on global public health
Example: The Bill & Melinda Gates Foundation provides more than $1 billion each year to support health technologies
BUSINESSES
Pharmaceutical companies donate >$1 billion in products each yea
Other companies make in-kind and monetary donations as part of their corporate social responsibility plans
PERSONAL DONATIONS
Millions of individuals make donations each yea
Americans donated nearly $300 billion to charity in 2011
73% from individuals rather than foundations or corporations
Represents about 2% of disposable income
TOTAL HEALTH EXPENDITURE AS A % OF GDP AND PRIVATE EXPENDITURE ON HEALTH AS A % OF TOTAL EXPENDITURE OF HEALTH, SELECTED COUNTRIES, 2009
Data from WHO. Global Health Observatory. Health expenditure ratios.
    COUNTRY    Health care Expenditure as % of GDP    Private Health Expenditure as % of Total Healthcare Expenditure        COUNTRY    Health care Expenditure as % of GDP    Private Health Expenditure as % of Total Healthcare Expenditure
    Indonesia    2.4    48.2        Haiti    6.1    77.9
    Pakistan    2.6    67.2        Vietnam    7.2    61.3
    Bangladesh    3.4    68.3        Sudan    7.3    72.6
    Philippines    3.8    65.1        Afghanistan    7.4    78.5
    Sri Lanka    4.0    54.8        Israel    7.6    41.1
    India    4.2    67.2        South Africa    8.5    59.9
    Thailand    4.3    24.2        Australia    8.5    32.3
    Kenya    4.3    66.2        Brazil    9.0    54.3
    Peru    4.6    41.4        Jordan    9.3    35.4
    Egypt    5.0    58.9        Ireland    9.7    20.4
    Cameroon    5.6    72.1        Costa Rica    10.5    32.6
    Nepal    5.8    64.7        Denmark    11.2    13.6
    Cambodia    5.8    72.7        France    11.7    20.8
    Nigeria    5.8    63.7        Cuba    11.8    6.9
    Dominican Republic    5.9    58.6        United States    16.2    51.4

Research Discussion Post
International Health System “Global Health”
Assignment & Instructions
Research Discussion TOPIC Question: - Discuss how health policy making is a political process?
To receive credit: 
Must be 500 words of actual text
_____________________________________________________________________________________
Answered Same Day Feb 05, 2023

Solution

Dipali answered on Feb 06 2023
33 Votes
WRITTEN ASSIGNMENT        2
WRITTEN ASSIGNMENT
Table of contents
Discussion    3
References    6
Discussion
    Making health policy is a difficult and dynamic political process that encompasses many different parties, interests, and viewpoints. The first step in the process is to identify a health problem or need, after which several policy choices are developed to address the issue. Stakeholders, such as government organizations, advocacy groups, healthcare providers, and the general public, who each
ing their own political and ideological viewpoints to the table, then discuss and The political process of health policy making is influenced by a number of factors, including negotiate these policy possibilities.
There are several aspects that affect the political process of developing health policy, including:
· Ideology: Political ideology plays a significant role in shaping health policy. For example, those on the political left may advocate for a larger role for the government in healthcare, while those on the political right may prefer a more market-based approach.
· Interest groups: Interest groups, such as advocacy organizations and professional associations, play an important role in influencing health policy. They may lo
y for specific policies or regulations, or against policies that they perceive as harmful to their interests (García, 2019).
· Power dynamics: The distribution of political power can also affect health policy making. For example, the political party in power may prioritize certain health issues over others, or may be more open to certain policy options than others may.
· Public opinion: Public opinion also plays a role in...
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