American health care: Why so costly?

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Author: The Commonwealth Fund

Date of publication: June 2003

Summary: Rising health care costs are of concern to policymakers, employers, health care leaders, and insured and uninsured Americans alike. The U.S. has relied on a mixed public–private system of insurance, managed care, and market competition to shape the health care system. Yet, the U.S. has the highest health care spending per capita in the world, and during the 1990s health spending in the U.S. rose faster than in other industrialized nations.

Regulating entrepreneurial behaviour in European health care systems

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Author: European Observatory on Health Systems and Policies Series

Date of publication: 2002

Summary: ..."Policy-makers often find themselves torn between two seemingly contradictory health sector objectives. On the one hand, shifting demography and improving technology generate strong interest in permitting innovative new procedures that can improve the ability of service providers to respond to the needs of patients. On the other hand, insufficiently tested interventions and inadequately thought-through schemes run the risk of damaging patients’ health and perhaps even their chances of survival. Faced with this conflict, many policy-makers feel that the only responsible path is to adopt a strong regulatory regime. Confronted by the unknown in the form of unleashed entrepreneurialism, they prefer the known consequences of static, often bureaucratic models of service design and delivery.

Workshop on Global Health Workforce Strategy, December 2000. HR and new approaches to public sector management: improving HRM capacity

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Author: World Health Organization (WHO)

Date of publication: 2001

Summary: This paper is divided into four main sections. The first section examines the broader context of public sector reform and draws out the implications of health reform for HR practices. The second section considers the contribution that HR can make to improved health sector effectiveness. The main section of paper considers how a more strategic approach to HR can be developed in the health sector, drawing on the existing evidence base, and emphasising the importante of ownership, external fit and internal fit. The vital role of the specialist HR function, and the different ways in which HR services can be delivered and audited, comprises the final section, prior to a brief conclusion.


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