This paper evaluates one of the first implemented provisions of the Patient Protection and Affordable Care Act (ACA) which permits young adults up to age 26 to enroll as dependents on a parent's private health plan. The paper also considers how the interaction between prior state laws expanding dependent coverage to young adults and the ACA affected young adult coverage. Using data from the Current Population Survey for calendar years 2004-2010, we apply a difference-in-differences framework to estimate how these provisions affected coverage of eligible young adults compared to slightly older adults. Our findings indicate that controlling for state laws, early implementation of the ACA increased young adult dependent coverage by 5.3 percentage points and resulted in a 3.5 percentage point decline in their uninsured rate. The interaction between state laws and the ACA suggests that the increase in dependent coverage and decline in the uninsured rate may have been greater among young adults who were targeted by both the ACA and state laws.
{"title":"The Role of Federal and State Dependent Coverage Eligibility Policies on the Health Insurance Status of Young Adults","authors":"J. Cantor, A. Monheit, D. Delia, Kristen Lloyd","doi":"10.3386/W18254","DOIUrl":"https://doi.org/10.3386/W18254","url":null,"abstract":"This paper evaluates one of the first implemented provisions of the Patient Protection and Affordable Care Act (ACA) which permits young adults up to age 26 to enroll as dependents on a parent's private health plan. The paper also considers how the interaction between prior state laws expanding dependent coverage to young adults and the ACA affected young adult coverage. Using data from the Current Population Survey for calendar years 2004-2010, we apply a difference-in-differences framework to estimate how these provisions affected coverage of eligible young adults compared to slightly older adults. Our findings indicate that controlling for state laws, early implementation of the ACA increased young adult dependent coverage by 5.3 percentage points and resulted in a 3.5 percentage point decline in their uninsured rate. The interaction between state laws and the ACA suggests that the increase in dependent coverage and decline in the uninsured rate may have been greater among young adults who were targeted by both the ACA and state laws.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132855783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Any country, no matter how big or small, is known by its people. The population signifies the existence of a country. The structure of the population determines the economic, social and political growth of the nation. A country can’t progress if its citizens are not sound economically, socially, politically and most important of all physically. Healthy masses lead to a healthy nation. Like any other necessity, good health is a basic requirement for hoi polloi who lead to a healthy economy. For the achievement of soundness of health of the masses, a country needs a sound and active health care system seeking to obtain longevity of lives, precluding sickness and promoting health services. The World Health Organization defines health as not only the absence of disease but also the presence of social well being, and physical and mental health.A health care system of a country is nothing but a structure where people, institutions etc join hand in hand to render good health service to the needy. Different countries have different health care systems having different kinds of organizational structures. They can be a constitution of private or public bodies or trusts aiming to ameliorate the health condition of the population. They send out their support even to the rural areas, sometimes free of cost. In a developing country like India where per capita income is low and a huge segment of the population is below the poverty line, medical facilities are extended free of cost to the people who need it. There are various plans and schemes chalked out to attain such objectives in various countries.
{"title":"The Threat of Armed Conflicts and the Impact of Health Care Services","authors":"Mitali Srivastava","doi":"10.2139/ssrn.2149899","DOIUrl":"https://doi.org/10.2139/ssrn.2149899","url":null,"abstract":"Any country, no matter how big or small, is known by its people. The population signifies the existence of a country. The structure of the population determines the economic, social and political growth of the nation. A country can’t progress if its citizens are not sound economically, socially, politically and most important of all physically. Healthy masses lead to a healthy nation. Like any other necessity, good health is a basic requirement for hoi polloi who lead to a healthy economy. For the achievement of soundness of health of the masses, a country needs a sound and active health care system seeking to obtain longevity of lives, precluding sickness and promoting health services. The World Health Organization defines health as not only the absence of disease but also the presence of social well being, and physical and mental health.A health care system of a country is nothing but a structure where people, institutions etc join hand in hand to render good health service to the needy. Different countries have different health care systems having different kinds of organizational structures. They can be a constitution of private or public bodies or trusts aiming to ameliorate the health condition of the population. They send out their support even to the rural areas, sometimes free of cost. In a developing country like India where per capita income is low and a huge segment of the population is below the poverty line, medical facilities are extended free of cost to the people who need it. There are various plans and schemes chalked out to attain such objectives in various countries.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134230732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Opponents of the Patient Protection and Affordable Care Act of 2010 assert that the ‘individual mandate’ is unprecedented, not just in the narrow and obvious sense that the federal government has never before required people to have health insurance, but in a much broader sense as well. They claim government even at the state level has never before required people to insure themselves. This article examines the assertion that the mandate is an unprecedented outlier and a sharp departure from all past government policies. This article finds that the laws in many states require drivers to purchase insurance coverage for their own injuries, that several states’ laws require drivers to buy coverage for their own medical expenses, and that liability insurance mandates protect careless drivers along with their victims. These long-standing individual insurance mandates have been overlooked by both sides in the current debate. As requirements for people to insure themselves, they are clear, powerful precedents for the health insurance individual mandate. If forced to admit that these laws exist, opponents may then claim that driving is a pure choice: If people object to state auto insurance laws, they can simply opt out and choose not to drive, while there is no opt-out from the individual health insurance mandate. The article argues that ‘driving as a pure choice’ is largely illusory and not a sufficient basis on which to argue that these precedents are irrelevant. Finally, the article turns to the forgotten history of auto insurance mandates, drawing lessons from that history for today’s debate. The history shows first that, leaving aside the Commerce Clause arguments which by definition only apply to the federal government, the arguments used to resist auto insurance mandates were strikingly similar to arguments used to oppose the health insurance individual mandate. Second, courts have consistently recognized a link between insurance and the public welfare justifying regulation in the auto context. Third, governments have recognized for decades that the auto insurance market must be regulated to provide a socially optimal level of coverage, as seen in the U.S. Supreme Court’s 1951 decision upholding a California market regulation law. Finally, state governments have long required people to purchase insurance for themselves from private sellers. The health insurance individual mandate is not different in kind from auto insurance individual mandates but rather extends the idea of insurance mandates to an even more important and compelling context.
{"title":"Is the Health Insurance Individual Mandate 'Unprecedented?': The Case of Auto Insurance Mandates","authors":"Jennifer B. Wriggins","doi":"10.2139/ssrn.2011025","DOIUrl":"https://doi.org/10.2139/ssrn.2011025","url":null,"abstract":"Opponents of the Patient Protection and Affordable Care Act of 2010 assert that the ‘individual mandate’ is unprecedented, not just in the narrow and obvious sense that the federal government has never before required people to have health insurance, but in a much broader sense as well. They claim government even at the state level has never before required people to insure themselves. This article examines the assertion that the mandate is an unprecedented outlier and a sharp departure from all past government policies. This article finds that the laws in many states require drivers to purchase insurance coverage for their own injuries, that several states’ laws require drivers to buy coverage for their own medical expenses, and that liability insurance mandates protect careless drivers along with their victims. These long-standing individual insurance mandates have been overlooked by both sides in the current debate. As requirements for people to insure themselves, they are clear, powerful precedents for the health insurance individual mandate. If forced to admit that these laws exist, opponents may then claim that driving is a pure choice: If people object to state auto insurance laws, they can simply opt out and choose not to drive, while there is no opt-out from the individual health insurance mandate. The article argues that ‘driving as a pure choice’ is largely illusory and not a sufficient basis on which to argue that these precedents are irrelevant. Finally, the article turns to the forgotten history of auto insurance mandates, drawing lessons from that history for today’s debate. The history shows first that, leaving aside the Commerce Clause arguments which by definition only apply to the federal government, the arguments used to resist auto insurance mandates were strikingly similar to arguments used to oppose the health insurance individual mandate. Second, courts have consistently recognized a link between insurance and the public welfare justifying regulation in the auto context. Third, governments have recognized for decades that the auto insurance market must be regulated to provide a socially optimal level of coverage, as seen in the U.S. Supreme Court’s 1951 decision upholding a California market regulation law. Finally, state governments have long required people to purchase insurance for themselves from private sellers. The health insurance individual mandate is not different in kind from auto insurance individual mandates but rather extends the idea of insurance mandates to an even more important and compelling context.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129642010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We investigate whether the implementation of electronic medical records is associated with higher levels of economic performance in nursing homes in terms of quality, profitability, cost, productivity, and efficiency. Our analysis is based on a survey of Healthcare Information Technology (HIT) usage for approximately 200 New York State Nursing Homes, including 26 that participated in the NY Nursing Home Demonstration project. The survey data are combined with regulatory data from CMS Nursing Home Compare and the NY State RHCF-4 financial reports. The analysis uses a “difference in differences approach” comparing changes in economic performance in a facility before and after HIT implementation to changes over the same time periods in other facilities that are known to not have implemented HIT. Overall, we do not find conclusive evidence that adoption of HIT raises productivity, increases commonly used performance measures, or improves quality scores in the short run. There is some evidence of a positive effect after several years. We do find that there appears to be a slight increase (1-3%) in variable costs, but also slightly greater efficiency when measured by frontier analysis. However, facilities that adopt HIT and either adopt or have in place progressive work practices (which include greater staff autonomy, cooperative labor-management relations, and greater teamwork) consistently show performance gains. Firms that are one standard deviation higher on our progressive work practice score get a 2-3% increase in productivity, a 2-3% reduction in costs and a 1-2% incremental efficiency gain upon adoption of HIT relative to their peers.Our results suggest that adoption of EMR can have significant positive economic benefits when implemented in conjunction with progressive work practices.
{"title":"Technical Report: The Business Case for Healthcare Information Technology in Nursing Homes","authors":"L. Hitt, Prasanna Tambe","doi":"10.2139/ssrn.1964841","DOIUrl":"https://doi.org/10.2139/ssrn.1964841","url":null,"abstract":"We investigate whether the implementation of electronic medical records is associated with higher levels of economic performance in nursing homes in terms of quality, profitability, cost, productivity, and efficiency. Our analysis is based on a survey of Healthcare Information Technology (HIT) usage for approximately 200 New York State Nursing Homes, including 26 that participated in the NY Nursing Home Demonstration project. The survey data are combined with regulatory data from CMS Nursing Home Compare and the NY State RHCF-4 financial reports. The analysis uses a “difference in differences approach” comparing changes in economic performance in a facility before and after HIT implementation to changes over the same time periods in other facilities that are known to not have implemented HIT. Overall, we do not find conclusive evidence that adoption of HIT raises productivity, increases commonly used performance measures, or improves quality scores in the short run. There is some evidence of a positive effect after several years. We do find that there appears to be a slight increase (1-3%) in variable costs, but also slightly greater efficiency when measured by frontier analysis. However, facilities that adopt HIT and either adopt or have in place progressive work practices (which include greater staff autonomy, cooperative labor-management relations, and greater teamwork) consistently show performance gains. Firms that are one standard deviation higher on our progressive work practice score get a 2-3% increase in productivity, a 2-3% reduction in costs and a 1-2% incremental efficiency gain upon adoption of HIT relative to their peers.Our results suggest that adoption of EMR can have significant positive economic benefits when implemented in conjunction with progressive work practices.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125516066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many studies conclude that the main reason Americans pay more for health care is that its providers charge higher prices. There is little agreement on why prices are higher. I argue that higher prices are caused by a type of insurance contract unique to America. “Service benefit” contracts originated by Blue Cross/Blue Shield plans paid no monetary “indemnity” to the people insured. Rather payments went directly to providers. Initially participating providers accepted the plan benefit as payment in full, and, so long as this remained true, these contracts provided no special incentive for providers to raise their prices. This changed around 1950, when independent insurance companies began to market a new type of policy called “major medical”. These policies were imitated by the Blues and, in so doing, they introduced “coinsurance” and “deductibles” provisions into the service benefit plans. In these new service benefit hybrids, providers were free to charge patients more than the plan benefit to be paid directly by the patient. An unintended consequence of this development was the release of an inflationary spiral. A model, based on the theory of two-sided matching, provides quantitative predictions of the increase in provider prices caused by insurance. The model can quantitatively account for the inflationary spiral observed from 1949 to 1959. If service benefit insurance is the major cause of the rise in provider prices, then a reform proposed here could reverse the spiral.
{"title":"Unique American Health Insurance Policies Cause Price Inflation","authors":"Michael P. Lynch","doi":"10.2139/SSRN.1899044","DOIUrl":"https://doi.org/10.2139/SSRN.1899044","url":null,"abstract":"Many studies conclude that the main reason Americans pay more for health care is that its providers charge higher prices. There is little agreement on why prices are higher. I argue that higher prices are caused by a type of insurance contract unique to America. “Service benefit” contracts originated by Blue Cross/Blue Shield plans paid no monetary “indemnity” to the people insured. Rather payments went directly to providers. Initially participating providers accepted the plan benefit as payment in full, and, so long as this remained true, these contracts provided no special incentive for providers to raise their prices. This changed around 1950, when independent insurance companies began to market a new type of policy called “major medical”. These policies were imitated by the Blues and, in so doing, they introduced “coinsurance” and “deductibles” provisions into the service benefit plans. In these new service benefit hybrids, providers were free to charge patients more than the plan benefit to be paid directly by the patient. An unintended consequence of this development was the release of an inflationary spiral. A model, based on the theory of two-sided matching, provides quantitative predictions of the increase in provider prices caused by insurance. The model can quantitatively account for the inflationary spiral observed from 1949 to 1959. If service benefit insurance is the major cause of the rise in provider prices, then a reform proposed here could reverse the spiral.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"288 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123102320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper analyses the public finance performance and the dynamics of government expenditures on education and health in the Kyrgyz Republic in 2007- 2010, when the country was hit by the global economic crisis and then by an internal political crisis in 2010. Despite these crisis conditions, public health expenditures have increased substantially. In education, recurrent expenditures have been protected, while capital investments have been cut dramatically. Both sectors suffer from chronic under-financing, which results in an insufficient quality of services. The country’s fiscal situation in the medium-term is going to be difficult, so efficiency-oriented reforms need to be implemented in health care and especially in education in order to sustain the development of these critical services in Kyrgyzstan.
{"title":"Public Expenditures on Education and Health in the Kyrgyz Republic Before and During the Global Crisis","authors":"Roman Mogilevsky","doi":"10.2139/ssrn.1873244","DOIUrl":"https://doi.org/10.2139/ssrn.1873244","url":null,"abstract":"This paper analyses the public finance performance and the dynamics of government expenditures on education and health in the Kyrgyz Republic in 2007- 2010, when the country was hit by the global economic crisis and then by an internal political crisis in 2010. Despite these crisis conditions, public health expenditures have increased substantially. In education, recurrent expenditures have been protected, while capital investments have been cut dramatically. Both sectors suffer from chronic under-financing, which results in an insufficient quality of services. The country’s fiscal situation in the medium-term is going to be difficult, so efficiency-oriented reforms need to be implemented in health care and especially in education in order to sustain the development of these critical services in Kyrgyzstan.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128704937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose – The purpose of this paper is to investigate the elements that health care personnel in Thailand believe are necessary for successful adoption of electronic medical record (EMR) systems.Design/methodology/approach – Initial qualitative in-depth interviews with physicians to adapt key elements from the literature to the Thai context. The 12 elements identified included things related to managing the implementation and to IT expertise. The nationwide survey was supported by the Ministry of Public Health and returned 1,069 usable questionnaires (response rate 42 percent) from a range of medical personnel.Findings – The key elements clearly separated into a managerial dimension and an IT dimension. All were considered fairly important, but managerial expertise was more critical. In particular, there should be clear EMR project goals and scope, adequate budget allocation, clinical staff must be involved in implementation, and the IT should facilitate good electronic communication.Research limitations/implications – Thailand is representative of middle-income developing countries, but there is no guarantee findings can be generalized. National policies differ, as do economic structures of health care industries. The focus is on management at the organizational level, but future research must also examine macro-level issues, as well as gain more depth into thinking of individual health care personnel.Practical implications – Technical issues of EMR implementation are certainly important. However, it is clear actual adoption and use of the system also depends very heavily on managerial issues. Originality/value – Most research on EMR implementation has been in developed countries, and has often focussed more on technical issues rather than examining managerial issues closely. Health IT is also critical in developing economies, and management of health IT implementation must be well understood.
{"title":"Key Success Factors Behind Electronic Medical Record Adoption in Thailand","authors":"Kanida Narattharaksa, M. Speece","doi":"10.2139/ssrn.1869483","DOIUrl":"https://doi.org/10.2139/ssrn.1869483","url":null,"abstract":"Purpose – The purpose of this paper is to investigate the elements that health care personnel in Thailand believe are necessary for successful adoption of electronic medical record (EMR) systems.Design/methodology/approach – Initial qualitative in-depth interviews with physicians to adapt key elements from the literature to the Thai context. The 12 elements identified included things related to managing the implementation and to IT expertise. The nationwide survey was supported by the Ministry of Public Health and returned 1,069 usable questionnaires (response rate 42 percent) from a range of medical personnel.Findings – The key elements clearly separated into a managerial dimension and an IT dimension. All were considered fairly important, but managerial expertise was more critical. In particular, there should be clear EMR project goals and scope, adequate budget allocation, clinical staff must be involved in implementation, and the IT should facilitate good electronic communication.Research limitations/implications – Thailand is representative of middle-income developing countries, but there is no guarantee findings can be generalized. National policies differ, as do economic structures of health care industries. The focus is on management at the organizational level, but future research must also examine macro-level issues, as well as gain more depth into thinking of individual health care personnel.Practical implications – Technical issues of EMR implementation are certainly important. However, it is clear actual adoption and use of the system also depends very heavily on managerial issues. Originality/value – Most research on EMR implementation has been in developed countries, and has often focussed more on technical issues rather than examining managerial issues closely. Health IT is also critical in developing economies, and management of health IT implementation must be well understood.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"314 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127424553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
European Union law prohibits direct-to-consumer advertising of medicinal products for human use that are subject to prescription. However, EU law does not clarify the borderline between advertising and provision of non-promotional information on medicines, the latter being not as yet regulated at EU level. This article examines the latest initiative launched by the European Commission to establish a Community legal framework on direct-to-consumer information on prescription medicines by the pharmaceutical industry. On the background of earlier attempts at reform and the growing body of case law of the European Court of Justice the article discusses whether the Commission proposal is likely to promote patient empowerment and prevent information from being used to persuade as opposed to empower patients.
{"title":"Push or Pull? – Information to Patients and European Law","authors":"L. Hancher, É. Földes","doi":"10.2139/SSRN.1865751","DOIUrl":"https://doi.org/10.2139/SSRN.1865751","url":null,"abstract":"European Union law prohibits direct-to-consumer advertising of medicinal products for human use that are subject to prescription. However, EU law does not clarify the borderline between advertising and provision of non-promotional information on medicines, the latter being not as yet regulated at EU level. This article examines the latest initiative launched by the European Commission to establish a Community legal framework on direct-to-consumer information on prescription medicines by the pharmaceutical industry. On the background of earlier attempts at reform and the growing body of case law of the European Court of Justice the article discusses whether the Commission proposal is likely to promote patient empowerment and prevent information from being used to persuade as opposed to empower patients.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117201591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Global health aid is exceedingly complex. It encompasses more than one hundred bilateral agencies, global funds, and independent initiatives that interact with an equally complex and diverse set of institutions involved in financing and providing health care in developing countries. Numerous efforts have been made to better coordinate these activities in the interest of making them more effective. The Health Systems Funding Platform is one of the most recent of these initiatives. Established in 2009, it has advanced farthest in two countries, Ethiopia and Nepal, and is currently expanding to several others. This paper briefly assesses the Platform and argues that the way the initiative is proceeding differs little from prior initiatives, such as sectorwide approaches and budget support. However, the initiative does represent an opportunity to make global health aid more effective if it were to deepen its commitment to improving information for policy, link funding explicitly to well-chosen independently verified indicators, and establish an evaluation strategy to learn from its experience.
{"title":"The Health Systems Funding Platform: Resolving Tensions between the Aid and Development Effectiveness Agendas","authors":"A. Glassman, W. Savedoff","doi":"10.2139/ssrn.1888411","DOIUrl":"https://doi.org/10.2139/ssrn.1888411","url":null,"abstract":"Global health aid is exceedingly complex. It encompasses more than one hundred bilateral agencies, global funds, and independent initiatives that interact with an equally complex and diverse set of institutions involved in financing and providing health care in developing countries. Numerous efforts have been made to better coordinate these activities in the interest of making them more effective. The Health Systems Funding Platform is one of the most recent of these initiatives. Established in 2009, it has advanced farthest in two countries, Ethiopia and Nepal, and is currently expanding to several others. This paper briefly assesses the Platform and argues that the way the initiative is proceeding differs little from prior initiatives, such as sectorwide approaches and budget support. However, the initiative does represent an opportunity to make global health aid more effective if it were to deepen its commitment to improving information for policy, link funding explicitly to well-chosen independently verified indicators, and establish an evaluation strategy to learn from its experience.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"290 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121264137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In past, the common legal concept of insanity defense was a concept of categories. Accordingly, in order to prevent imposition of criminal liability upon the offender out of insanity, the offender should have been recognized as suffering of "mental disease". Only if the mental disease could have been related to a specific list of diseases, the offender could have been considered as insane. Medical major developments and legal developments since the nineteenth century brought up changes in this concept. The dynamic psychiatry, which became major measure in mental disorder understanding, compelled a deep change in the former concept. It is argued, that any mental disorder should be examined functionally, and not by categories, as to the application upon the defense of insanity in criminal law. Only under functional examination, it is possible to seriously examine cases of temporary insanity or partial insanity. The article argues for the functional examination of mental disorder as the necessary measure to examine the applicability of the insanity defense in criminal law.
{"title":"Modern Examination of Insanity Defense in Criminal Law Under the Development of the Dynamic Psychiatry – From Categorization to Functionalism","authors":"Prof. Gabriel Hallevy","doi":"10.2139/SSRN.1840355","DOIUrl":"https://doi.org/10.2139/SSRN.1840355","url":null,"abstract":"In past, the common legal concept of insanity defense was a concept of categories. Accordingly, in order to prevent imposition of criminal liability upon the offender out of insanity, the offender should have been recognized as suffering of \"mental disease\". Only if the mental disease could have been related to a specific list of diseases, the offender could have been considered as insane. Medical major developments and legal developments since the nineteenth century brought up changes in this concept. The dynamic psychiatry, which became major measure in mental disorder understanding, compelled a deep change in the former concept. It is argued, that any mental disorder should be examined functionally, and not by categories, as to the application upon the defense of insanity in criminal law. Only under functional examination, it is possible to seriously examine cases of temporary insanity or partial insanity. The article argues for the functional examination of mental disorder as the necessary measure to examine the applicability of the insanity defense in criminal law.","PeriodicalId":230649,"journal":{"name":"Health Care Law & Policy eJournal","volume":"157 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132705897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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