This book mounts a critique of current health economics and provides a better way of looking at the economics of health and health care. It argues that health economics has been too dominated by the ...economics of health care and has largely ignored the impact of poverty, inequality, poor housing, and lack of education on health. It is suggested that some of the structural issues of economies, particularly the individualism of neo liberalism which is becoming more and more pervasive across the globe, need to be addressed in health economics. The author instead proposes a form of collective decision making through communitarianism, placing value on participation in public life and on institutions, such as health care. It is envisaged this form of decision making can be used at the local, national or global levels. For the last, this would mean a major revamp of global institutions like the World Bank and the IMF. Examples of the impact of the new paradigm on health policy in general but also more specifically on priority setting and equity are included. Available in OSO: http://www.oxfordscholarship.com/oso/public/content/economicsfinance/9780199235971/toc.html
This book is about equity in health and health care. It explores why, despite being seen as an important goal, health equity has not made more progress within countries and globally, and what needs ...to change for there to be greater success in delivering fairness. An international team of eminent experts from primarily the field of health economics describe how equity in health and health care might develop over the next decade. They examine existing and past barriers to promoting equity, citing case examples, and covering issues including access to health services and inequalities between and within countries. The analyses are detailed, but the issues are approached in an accessible fashion, highlighting the factors of common international relevance. This book provides a manifesto for achieving health equity for the future. It will be essential reading for health and social policy makers, and health academics nationally and internationally.
As we are dealing with the people's health, the people's voice needs to drive the principles underpinning our health care system.
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7.
The health of nations Mooney, Gavin; Navarro, Vicente
2012., 2012, 2012-04-12, 20120101, Volume:
56514
eBook
Why, despite vast resources being expended on health and health care, is there still so much ill health and premature death? Why do massive inequalities in health, both within and between countries, ...remain? In this devastating critique, internationally renowned health economist Gavin Mooney places the responsibility for these problems firmly at the door of neoliberalism. Mooney analyses how power is exercised both in health-care systems and in society more generally. In doing so, it reveals how too many vested interests hinder efficient and equitable policies to promote healthy populations, while too little is done to address the social determinants of health. Instead, Mooney argues, health services and health policy more generally should be returned to the communities they serve. Taking in a broad range of international case studies - from the UK to the US, South Africa to Cuba - this provocative book places issues of power and politics in health care systems centre stage, making a compelling case for the need to re-evaluate how we approach health care globally.
This article considers two key issues in health economics regarding the question of equity. First, why have health economists not resolved better the issue of what are equity and access? Second, the ...paper draws attention to the relative lack of analyses of equity concerns outside of health care. The question of whose values should prevail in equity is also addressed. On the first issue, there is an obsession with quantification in economics with the result that in analysing equity, in practice often ‘use’ has been substituted for ‘access’. The problem of defining access has thereby been by-passed. This has taken the pressure off trying to research access per se. Second, what is meant by equity and access are in part culturally determined. The continued efforts of health economists to treat equity as some universal construct are misplaced. The lack of effort on the part of health economists to look at equity more broadly than health care equity is concerning. Certainly, to be pursued in practice, equity in both health and health care need a shift in resources, which will be opposed by those who exercise power over decision making in health care and in society more generally. Currently health economists’ analyses say all too little about power and property rights in health care and in society. It is argued that the relevant citizens or communities which a health service serves are best placed to judge the access barriers they face and their relative heights. A useful definition of equity established by a citizens’ jury in Perth, Australia is used to exemplify this point. It is concluded that the often all too simplistic equity goals adopted in health economics (and sometimes public health discourse) need to be challenged. For health economists, there is a need for more of us to get involved in the issues around inequalities, class and power and the impact of these on health.
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There is growing interest in involving the public in decisions about healthcare provision.
Citizens’ juries, whose members were randomly selected from the electoral roll (rather than derived from ...consumer interest groups), have been trialled in Western Australia.
When asked to take a community focus, presented with balanced evidence and given time to discuss and deliberate, the juries were able to identify and debate issues of broad principle, such as equity. Such issues seem to be best handled by referring to community values.
Any public consultation process should provide sufficient information, opportunity for reflection and deliberation, and recognition of the scarcity of resources.
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