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Wyświetlanie 1-10 z 36
Tytuł:
Around privatisation in health care : some issues
Wokół prywatyzacji w ochronie zdrowia : kilka problemów
Autorzy:
Włodarczyk, Cezary
Opis:
In recent years Polish health system underwent a lot of changes. One of their important dimensions was a balance between public and private. Before 1989 the system was almost completely public and the idea to boost private segment was raised many times. It was propagated mostly by a group of outstanding medical professional who hoped it to be beneficial for them as well as by a few economists believing in market efficiency, but their position was too weak to alter political decisions and privatisation has never explicitly been declared as a priority of national reform. Nevertheless privatisation appeared from time to time as a hidden goal of some health care reform initiatives and a substantial part of health care providers – mostly in out-patient care – has been privatised. Public convictions and beliefs make a psychological bedrock in which health system can be transformed. Many surveys reveal the Polish population is rather confused in their perception of private segment of health care provision. They approve private providers in verbal declarations which are believed to be more accessible, but are afraid of having to pay in privatised hospitals. The people are not ready to be charged with fees. In early stages of the reform an idea of setting up a structure to negotiate collectively terms of work was very popular. But launching the “Providers’ Alliance“ (Porozumienie Zielonogorskie ) in 2004 resulted rather from urgent need to negotiate contracts between PHC providers and the payer than from democratic concept. Physicians demanded many concessions from administration - working time, free Saturdays and Sundays – and they managed to get them. It was definitely against all promises given at first stages of health care reform. What more, all these concessions were approved by the authorities as binding in all country wide negotiations between the payer and providers. One of the most important component of proposals presented by the government referred to the law on health care institutions. The inherited arrangements ("independent public healthcare institutions" or SPZOZ) were seen to confine chances to make optimal decisions. Making them more flexible seemed to be a prerequisite to better management and better meeting health needs of population. According to proposals a health institution could be run in the form of a company (in terms of the Code of Trade). Such transformation was intended to increase the managerial possibilities for hospital management to operate in more efficient way.. Equally important was to implement a rule of a stronger accountability - mostly financial - for decision makers responsible for running hospitals. In early nineties the concept of patient right was hardly recognisable even if a list had been included in the law. One of areas where patients’ dignity was violated was obstetrician: conditions of delivery which were very poor. It was certainly the problem of scarce resources but also of attitudes shared and demonstrated to women. In 1994 the largest newspaper "Gazeta Wyborcza" proclaimed a campaign entitled "Childbirth with Dignity". At the time the reason to do so was to initiate a public discussion on the subject, which was a taboo for years, but actually it contributed to change the situation substantially.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Problemy nierówności w zdrowiu. Perspektywa Unii Europejskiej
Problems of health inequalities. European Union perspectives
Autorzy:
Włodarczyk, Cezary
Tematy:
european integration
health equality
health justice
integracja europejska
równość w zdrowiu
sprawiedliwość w zdrowiu
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Wydawca:
Uniwersytet Jagielloński. Wydawnictwo Uniwersytetu Jagiellońskiego
Powiązania:
https://bibliotekanauki.pl/articles/635054.pdf  Link otwiera się w nowym oknie
Opis:
In European Union democratic values have been approved unquestionably. They may be derived from many sources like from its own, dignified tradition linking back to Declaration of the Rights of Man and of the Citizen of 1789 or United Nations documents. In the Lisbon Treaty on functioning of European Union there are words about the space of freedom, safety and justice, equality between men and women, and equality of chances. UE has obliged itself fighting against all forms of inequalities and discrimination. As one of authors said: equality, cohesion and social justice this is the material of which Europe is constructed. They are not only the object of declarations and recommendations, but active implementation attentively watched by the whole world. In this paper I deal with two aspects of the workings undertaken within the UE which are aimed at reduction of health inequalities. First refers to actions resulting from common initiatives, therefore activities belonging to responsibility shared by EU and member countries. In second part questions raised from initiatives promoted by countries holding presidency are analysed. Rather frequently these countries made a very essential influence on the way of perception and solving the problems of health inequalities.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Health care reform as a political process : some remarks on selected clues
Reforma zdrowotna jako proces polityczny : kilka uwag o wybranych wątkach
Autorzy:
Włodarczyk, Cezary
Opis:
Health sectors (systems) have always been undergoing many changes But in late eighteens changes were intensified and looked at as something specific and referred to as "health reforms". Though changes considered and implemented in different countries varied, most observers underlined the similarities occurring in reforms, especially in industrialized countries. In this paper reforms in United Kingdom, Sweden and New Zealand are analyzed. In early nineties all these countries had comprehensive health systems, emphasizing the rule o f public responsibility. All made decision to implement a number of market-oriented mechanisms, relying on concepts o f internal market, competition, provider-purchaser split and appreciating the role of private sector. The reforms resulted in limited successes but were abandoned after shorter or longer periods. All countries gave up market slogans and returned to rules of public (state’s) responsibility, even if solutions that proved efficient were preserved. A question on factors contributing to two problems is posed. First, why market-oriented solutions were accepted and implemented so easily and broadly. Second, why market-oriented solutions, once in use, were so willingly rejected. My hypothesis is that the answers should be sought in characteristics o f political process in which health reform was being prepared and implemented.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Koncepcja „Oceny wpływu na zdrowie” (Health Impact Assessment) i jej wykorzystywanie w Unii Europejskiej. Perspektywa sektora prywatnego
Autorzy:
Włodarczyk, Cezary W.
Tematy:
Health Impact Assessment, UE, health policy, private sector
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Wydawca:
Uniwersytet Jagielloński. Wydawnictwo Uniwersytetu Jagiellońskiego
Powiązania:
https://bibliotekanauki.pl/articles/634977.pdf  Link otwiera się w nowym oknie
Opis:
Concept of Health Impact Assessment and its application in European Union. Private sector dimensionAccording to the WHO definition Health Impact Assessment (HIA) refers to “procedures, methods and tools by which a policy, programme  or project may be judged as to its potential effects on the health of the population and the distribution of those effects within the population”. HIA has emerged from weather forecasts and is founding much  broader use. It helps to identify the factors, which have a potential impact on health. HIA may be relevant for all sectors to determine the effects, also unintentional, of their policies and actions on health and it has the potential to bring greater transparency to the decision-making process. Usually, it is very important to be able to foresee future health related effects, also by clarifying the nature of trade-offs in policy. Comparing and judging wanted and unwanted results is essential to choose a possibly best alternative and avoid harm. In European Union where modern tools to rationalize decision making process are broadly accepted HIA has been welcomed, at least in declarations. Although some approaches to assess actions targeted at environment have been formalized and are binding, but others, including HIA, still depend on good will of partners involved. Both member countries and institutions are a bit reserved to use HIA. Insufficient popularity of HIA may result from scarce educational opportunities but also from deficit in well grounded scientific evidence.
Dostawca treści:
Biblioteka Nauki
Artykuł
Wyświetlanie 1-10 z 36

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