Access Delayed, Access Denied: Waiting for New Medicines in Canada 2011 by Mark Rovere, Brett Skinner :: SSRN

Federal and provincial government policies create unnecessary delays for patients wanting access to new drug treatments. The federal government does not allow patients to use new drugs until Health Canada has reviewed each product’s safety and effectiveness information. The latest data show that in 2009 Health Canada took 472 days on average to approve new drugs, up from 388 days in 2008. Health Canada took longer to approve new drugs than regulators in Europe in all four years studied (2006 to 2009) and longer than the American FDA in five of the last six years studied (2004 to 2009). Relative to other countries, Canadian patients wait too long for government permission to use new drug treatments.

via Access Delayed, Access Denied: Waiting for New Medicines in Canada 2011 by Mark Rovere, Brett Skinner :: SSRN.

Critics Pounce on Cancer Care Costs Study | GoozNews

Why do the authors use the wrong metric – survival – in the analysis and then argue that the right measure – mortality – provides corroborating evidence?” asked Welch. “As long as your calculation is based on survival gains, it is fundamentally misleading.”Other calculations cast doubt on the superiority of U.S. cancer care. For instance, breast cancer mortality fell 36 percent in the United Kingdom from 1990 to 2006, calculates MD Anderson’s Berry, and fell 30 percent among whites in the United States. The U.S. figure would be even lower, he said, if it included African-Americans, who generally have less access to health care.Cancer mortality in the United States is higher than in 11 countries reporting to the Organization for Economic Co-operation and Development, and lower than the rate in 14. Mortality is lower in Switzerland, Sweden, Japan and Finland, among others, but higher in Hungary, Slovenia, France and Britain, in the latest years for which OECD has data.

via Critics Pounce on Cancer Care Costs Study | GoozNews.

Competition-Based Reform of the National Health Service in England: A One-Way Street? by Lucy Reynolds, Amir Attaran, Tamara Hervey, Martin McKee :: SSRN

The Conservative-led government in the United Kingdom is embarking on massive changes to the National Health Service in England. These changes will create a competitive market in both purchasing and provision. Although the opposition Labour Party has stated its intention to repeal the legislation when it regains power, this may be difficult because of provisions of competition law derived from international treaties. Yet there is an alternative, illustrated by the decision of the devolved Scottish government to rejectcompetitive markets in health care.

via Competition-Based Reform of the National Health Service in England: A One-Way Street? by Lucy Reynolds, Amir Attaran, Tamara Hervey, Martin McKee :: SSRN.

Toward Universal Health Coverage – NYTimes.com

Except for the United States, the 25 wealthiest nations now have some form of it. Others are not far behind, including Brazil and Thailand. Even nations at lower income levels, such as the Philippines, Vietnam, Rwanda and Ghana are working toward it. India, South Africa, China and Colombia are on the move, too.

via Toward Universal Health Coverage – NYTimes.com.

Books | Health Care in Canada: A Citizen’s Guide to Policy and Politics

Katherine Fierlbeck. Health Care in Canada: A Citizen’s Guide to Policy and Politics. Toronto: University of Toronto Press, 2010. 382 + xiv pp. C$85.00 cloth; C$37.95 paper. Reviewed in Journal of Health Politics, Policy and Law published 30 March 2012, 10.1215/03616878-1597520. http://jhppl.dukejournals.org/cgi/rapidpdf/03616878-1597520v1

Healthcare in Italy: Expenditure Determinants and Regional Differentials by Maura Francese, Marzia Romanelli :: SSRN

The aim of this work is to identify the determinants of health spending differentials among Italian regions, which could highlight the existence of potential margins for savings. The analysis exploits a dataset for the panel of the 21 Italian regions starting in the early 1990s and ending in 2006. After having controlled for standard healthcare demand indicators, spending differentials appear to be associated with differences in the degree of appropriateness of the treatments, supply structure and social capital indicators. These results suggest that savings could be achieved without reducing the amount of services supplied to citizens. This is particularly important in view of the expected rise in health spending associated with the forecast demographic developments.

via Healthcare in Italy: Expenditure Determinants and Regional Differentials by Maura Francese, Marzia Romanelli :: SSRN.

Making Sense of the Global Health Crisis: Policy Narratives, Conflict, and Global Health Governance

Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the “global health crisis.” Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis.

via Making Sense of the Global Health Crisis: Policy Narratives, Conflict, and Global Health Governance.

Association of Hospital Spending Intensity With Mortality and Readmission Rates in Ontario Hospitals, March 14, 2012, Stukel et al. 307 (10): 1037 — JAMA

Among Ontario hospitals, higher spending intensity was associated with lower mortality, readmissions, and cardiac event rates.

via Association of Hospital Spending Intensity With Mortality and Readmission Rates in Ontario Hospitals, March 14, 2012, Stukel et al. 307 (10): 1037 — JAMA.

UK Health Care | Privatization | Obamacare | The Daily Caller

Filmmaker Michael Moore glorified the United Kingdom’s National Health Service in his 2007 documentary ”Sicko,” making a cult film argument that socialized medicine works. But Prime Minister David Cameron, the Tory MP who heads a coalition government in England, is apparently not a Moore fan: He is working to partially privatize the NHS, beginning a massive outsourcing of medical services to private health care providers throughout the U.K.

Britain’s media, in particular the Washington Post–Huffington Post hybrid The Guardian, is publishing near-panic-attacks alerts daily about the conservative plan, which comes as the British government scales back on entitlement spending, hoping to avoid a Greek-style financial meltdown.

via UK Health Care | Privatization | Obamacare | The Daily Caller.

Perceptions of the Health System and Public Trust in Government in Low- and Middle-Income Countries: Evidence from the World Health Surveys

In low- and middle-income countries, health care systems are an important means by which individuals interact with their government. As such, aspects of health systems in these countries may be associated with public trust in government. Greater trust in government may in turn improve governance and government effectiveness. We identify health system and non – health system factors hypothesized to be associated with trust in government and fit several multilevel regression models to cross-national data from 51,300 respondents in thirty-eight low- and middle-income countries participating in the World Health Surveys. We find that health system performance factors are associated with trust in government while controlling for a range of non – health system covariates. Taken together, higher technical quality of health services, more responsive service delivery, fair treatment, better health outcomes, and financial risk protection accounted for a 13 percent increase in the probability of having trust in government. Health system performance and good governance may be more interrelated than previously thought. This finding is particularly important for low-income and fragile states, where health systems and governments tend to be weakest. Future research efforts should focus on determining the causal mechanisms that underlie the observed associations between health system performance and trust in government.

via Perceptions of the Health System and Public Trust in Government in Low- and Middle-Income Countries: Evidence from the World Health Surveys.