The health debate: Policy & Politics in the Twenty-First Century (Policy and Politics in the Twenty-first Century Series) Review

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(More customer reviews)This is an important analysis of the mismanagement of the UK NHS in the last twenty years. The UK NHS is both a good example and a dire warning to the rest of the world. It's a good example in that we achieve population coverage to some level. The dire warning bit is that the standards (of access, and outcomes achieved) are not as high as we like to think, or as good as in comparable European countries.
Imagine a car company that did not like its engineers. That's about the relationship between NHS management and the doctors and nurses who deliver the care to patients. Hunter clearly shows the problems that such an attitude causes and reminds us, ""As any change management text will state, the chances of ensuring that successful implementation occurs are seriously impaired if those working on the front line are not signed up to the changes and seek to contest, or undermine them.....A key feature of the most recent changes in the NHS in England is that the key professions have been disengaged from the reform process"
The UK NHS is a dire warning to others. It has consumed vast amounts of policy ideas and money, and delivered little in return for all the investment spent on it. The processes of change have been disruptive, faddy, and not sustained rather than constructive with long term outcomes in mind. Hunter describes the policies and their botched implementation carefully, and is clear about the consequences. The book is clearly written and well referenced, and so makes a strong case for its conclusions.
The tragedy is that all of us are suffering from this- doctors, patients, managers, voters, taxpayers, politicians.
Read this excellent book to find out where things have gone wrong in the NHS and why. And then make a note that centralized top down schemes which do not engage the workers will never succeed. No matter how much you paid the management consultants and special advisers to write them.
And if Americans are looking for a scheme to emulate then the UK NHS probably is not it.

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Exploring Social Insurance: Can a Dose of Europe Cure Canadian Health Care Finance? (School of Policy Studies) Review

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(More customer reviews)I picked up this book as an after thought because right of the bat it seems dense and wordy (which it is). I was thinking I'd skim through the chapters to catch the gist of what was written - however I was pleasantly surprised at the quality of writing (this book has been well edited). This is a great collection of individual work created by various academics/contributors. The basic premise of the book is an investigation into the question of : "Can social insurance be made a part of the Canadian health care financing framework ? ".
The book has arguments for and against this question. Reading well researched and clearly expressed opinions from both sides of the debate was a refreshing change from the usual text of this nature which only talks about one point of view (the authors) ! The book does not give a definite answer , rather I felt it was allowing the reader to create his own opinion (at least I was inspired look at other debates in the US and UK systems).
Great book and highly recommended.

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Sustainability, quality, and accessibility are vital questions in health care. All Canadian governments, concerned about the growing share of the public budget absorbed by health care, are questioning the sustainability of the present system. How can we maintain and improve access to health care services of appropriate quality while ensuring sustainability? If there is one consolation to Canadian governments as they wrestle with the future of Medicare, it is that sustainability concerns are not unique to Canada but affect all countries, regardless of the level of private financing in a system. Some countries, however - particularly social insurance countries in Northern Europe such as Germany and France - manage to achieve universal access without wrestling with waiting lists, while providing a wide range of services. This book examines whether the grail of sustainability, quality, and accessibility could be better achieved through a marriage of the traditional Canadian model with elements of a European system.

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Healthy Competition: What's Holding Back Health Care and How to Free It Review

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(More customer reviews)I enjoyed the book and found it presented a well organized argument for why it is so critical to allow the markets and consumers to experiment with new methods of controlling health care costs and improving access. I also appreciated the author's acknowledgement that health care is a special service that is critically important in our lives. That is what makes reforming the system so challenging.
The book makes clear that market based proposals to reform health care are designed to lower the cost of care and increase coverage. These are proposals that are critical to all Americans.

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