Restructuring Health Services

Changing Contexts and Comparative Perspectives

Edited by Kasturi Sen


The contributors to this volume review the debates about financing health care and its relationship to privatization.
Health service delivery is being restructured in both industrialised and developing countries. Public health scholars and policy makers in this volume show how this process is accelerating as a result of diverse factors including fiscal pressure, privatisation of infrastructure, and the impending renegotiation of the WTO General Agreement on Trade in Services (GATS).

The key policy issues that arise concern the implications of these changes for access and equity in public health provision.

The volume reviews the rapidly changing context in which financing health care and its relationship to globalization and privatisation are taking place. It examines the specific mechanisms and institutional processes involved. And it explores various contrasting experiences, including HMOs in the USA, Britain's NHS, social health insurance in Western Europe, developing countries, and Cuba.

Author Bio

Kasturi Sen teaches at the Institute of Public Health, Department of Public Health, University of Cambridge.

Table of Contents

1. Introduction: Restructuring Health Services - Public Subsidy of Private Provision - Kasturi Sen

PART I: Conceptual and Legislative framework
    • 2. Restructuring Health Services and the Politics of Privatisation - An Overview of Experience - Kasturi Sen
    • 3. Trading Health Care Away: The WTO's General Agreement on Trade in Services (GATS) - Sarah Sexton
    • 4. Ethics and Medical Care in a Globalising World: Some Reflections - Imrana Qadeer
PART II: The Process of Change
    • 5. Assessing Health Systems Performance: A Critical Appraisal of the WHO World Health Report 2000 - Claudia Travassos
    • 6. Multinational Corporations and the Pattern of Privatisation in Health Care - David Hall
    • 7. Health Systems Solidarity and European Community Policies - Meri Koivusalo
PART III: Case studies of Restructuring: Comparative Perspectives
    • 8. The Impact of Social Health Insurance Reform on Social Solidarity in Four European Countries - Hans Maarse and Aggie Paulus
    • 9. Restructuring Health Services in Italy: The Paradox of Devolution - Francesco Taroni
    • 10. Global Capital and Health Care Reform: The Experience of the UK - Jean Shaoul
    • 11. The Trouble with Conservative Health Care Counter Reforms in Spain - M. Sanchez Bayle and Hixinio Beiras
    • 12. The Sad Experience of Corporate Health Care in the USA - Steffie Woolhandler
    • 13. Transformation of the Cuban Health Sector: The Past Forty Years - Felix. J. Sanso Soberats
    • 14. The Political Economy of Health Care Reforms in Malaysia - Chan Chee Khoon
    • 15. Implementing Universal Health Care Coverage in Thailand - Sanguan Nitayarumphong and Supasit Pannarunothai
    • 16. The Role of the State in the Privatisation and Corporatisation of Medical Care in Andhra Pradesh, India - K.V. Narayana


'This book documents many instances of the poor social, medical and economic outcomes of health care privatisation... and exposes this fashionable ideology for the empty science that it is.'
Jean-Pierre Unger, Institute of Tropical Medicine, Antwerp, Belgium

'This is an important book for those wanting to understand what is happening to our health services.'
Maureen Mackintosh, Professor of Economics, the Open University


Publication Date: 1 February 2003
272 pages

Product ISBNs: Paperback: 9781842772898
Library Edition: 9781842772881

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