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Chapter 5 - Health Systems and Health and Healthcare Reform

from Section 1 - Global Health: Definitions and Descriptions

Published online by Cambridge University Press:  04 February 2021

By
Martin McKee
Edited by
Solomon Benatar  and
Gillian Brock
Solomon Benatar
Affiliation:
Emeritus Professor of Medicine, University of Cape Town
Gillian Brock
Affiliation:
Professor of Philosophy, University of Auckland
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Summary

It is easy to forget that one of the primary purposes of a health system should be to improve health (McKee et al., 2009). For decades, debates on health systems have been dominated by discussions of how much they cost to run (typically questioning whether they are affordable, as if there were an alternative in a civilized society) or how many resources they require (typically expressed in an arbitrary fashion as people, usually doctors and nurses, but not managers or physiotherapists, or facilities and items of furniture, usually hospitals, but not primary care clinics or beds and not examination couches). The nature of this discourse has meant that health systems have tended to be regarded as a cost to society from which there is little return instead of as an investment whereby appropriately directed expenditure leads to better health.

Type
Chapter
Information
Global Health
Ethical Challenges
 , pp. 86 - 97
Publisher: Cambridge University Press
Print publication year: 2021

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References

Anand, S., & Ravallion, M. (1993). Human development in poor countries: on the role of private incomes and public services. Journal of Economic Perspectives 7, 133–150.CrossRefGoogle Scholar
Arora, S. (2001). Health, human productivity, and long-term economic growth. Journal of Economic History 61, 699–749.Google Scholar
Atun, R. A., Gurol-Urganci, I., & McKee, M. (2009). Health systems and increased longevity in people with HIV and AIDS. British Medical Journal, 338:b2165.CrossRefGoogle ScholarPubMed
Balabanova, D., Mills, A., Conteh, L., et al. (2013). Good health at low cost 25 years on: lessons for the future of health systems strengthening. Lancet 381, 2118–2133.CrossRefGoogle ScholarPubMed
Baum, F., Popay, J., Delany-Crowe, T., et al. (2018). Punching above their weight: a network to understand broader determinants of increasing life expectancy. International Journal of Equity Health 17, 117.CrossRefGoogle Scholar
Bloomer, E., & McKee, M. (2018). Policy options for reducing antibiotics and antibiotic-resistant genes in the environment. Journal of Public Health Policy 39, 389–406.CrossRefGoogle ScholarPubMed
Bor, J. (2017). Diverging life expectancies and voting patterns in the 2016 US presidential election. American Journal of Public Health 107, 1560–1562.Google Scholar
Burki, T. K. (2016). Sugar tax in the UK. Lancet Oncology 17, e182.CrossRefGoogle ScholarPubMed
Choi, S., Park, S., & Kim, S. Y. (2018). A comparative study on the constitutional right to health in the western Pacific region countries. Asia Pacific Journal of Public Health 30, 458–469.Google Scholar
Colgrove, J. (2002). The McKeown thesis: a historical controversy and its enduring influence. American Journal of Public Health 92, 725–729.Google Scholar
Commission on Macroeconomics and Health (2001). Macroeconomics and Health: Investing in Health for Economic Development: Report of the Commission on Macroeconomics and Health. Geneva: WHO.Google Scholar
Doyle, Y., McKee, M., Rechel, B., & Grundy, E. (2009). Meeting the challenge of population ageing. British Medical Journal 339, b3926.Google Scholar
European Commission (2008). Lisbon Strategy. Brussels: European Commission.Google Scholar
Expert Panel on Effective Ways of Investing in Health (2018). Benchmarking Access to Healthcare in the EU, Brussels: European Commission.Google Scholar
Fogel, R. W. (1994). Economic growth, population theory, and physiology: the bearing of long-term processes on the making of economic policy (NBER Working Paper No. 4638), National Bureau of Economic Research, Cambridge, MA.Google Scholar
Forman, L., Beiersmann, C., Brolan, C. E., et al. (2016). What do core obligations under the right to health bring to universal health coverage? Health and Human Rights 18, 23–34.Google Scholar
GBD 2015 Healthcare Access and Quality Collaborators (2017). Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015. Lancet 390, 231–266.CrossRefGoogle Scholar
GBD 2016 Causes of Death Collaborators (2017). Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390, 1151–1210.Google Scholar
GBD 2016 Stroke Collaborators (2019). Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurology 18, 439–458Google Scholar
Grad, F. P. (2002). The preamble of the constitution of the World Health Organization. Bulletin of the WHO 80, 981–981.Google Scholar
Hamilton, M., Thompson, E., & Wisniewski, T. (1964). The role of blood-pressure control in preventing complications of hypertension. Lancet 283, 235–238.Google Scholar
Hiam, L., Harrison, D., McKee, M., & Dorling, D. (2018a). Why is life expectancy in England and Wales “stalling”? Journal of Epidemiology and Community Health 72, 404–408.Google Scholar
Hiam, L., Steele, S., & McKee, M. (2018b). Creating a “hostile environment for migrants”: the British government’s use of health service data to restrict immigration is a very bad idea. Health Economics, Policy and Law 13, 107–117.Google Scholar
Illich, I. (1976). Medical Nemesis: The Expropriation of Health. New York: Pantheon Books.Google Scholar
Institute of Medicine (2000). To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press.Google Scholar
Laing, R. (2010). The Divided Self: An Existential Study in Sanity and Madness. London: Penguin Books.Google Scholar
Lecky, F., Woodford, M., & Yates, D. (2000). Trends in trauma care in England and Wales 1989–97. Lancet 355, 1771–1775.CrossRefGoogle ScholarPubMed
Legido-Quigley, H., Pajin, L., Fanjul, G., Urdaneta, E., & McKee, M. (2018). Spain shows that a humane response to migrant health is possible in Europe. Lancet Public Health 3, e358Google Scholar
Mackenbach, J., Meerding, W. J., & Kunst, A. (2007). Economic Implications of Socio-economic Inequalities in Health in the European Union. Brussels: European Commission.Google Scholar
Matsuura, H. (2013). The Effect of a Constitutional Right to Health on Population Health in 157 Countries, 1970–2007: The Role of Democratic Governance. Cambridge, MA: Program on the Global Demography of Aging.Google Scholar
Mazzucato, M. (2015). The Entrepreneurial State: Debunking Public vs. Private Sector Myths. London: Anthem Press.Google Scholar
McGrail, K., Green, B., Barer, M. L., et al. (2000). Age, costs of acute and long-term care and proximity to death: evidence for 1987–88 and 1994–95 in British Columbia. Age and Ageing 29, 249–253.Google Scholar
McKee, M., & Kluge, H. (2018). Include, invest, innovate: health systems for prosperity and solidarity. Journal of Health Services Research & Policy 23, 209–211.Google Scholar
McKee, M., Suhrcke, M., Nolte, E., et al. (2009). Health systems, health, and wealth: a European perspective. Lancet 373, 349–351.Google Scholar
McKeown, T. (1976). The Role of Medicine: Dream, Mirage, or Nemesis? Princeton, NJ: Princeton University Press.Google Scholar
Moon, S., Szlezák, N. A., Michaud, C. M., et al. (2010). The global health system: lessons for a stronger institutional framework. PLoS Medicine 7, e1000193.Google Scholar
National Cancer Institute (2018). Biological Therapies for Cancer (online). Available at www.cancer.gov/about-cancer/treatment/types/immunotherapy/bio-therapies-fact-sheet (accessed April 4, 2019).Google Scholar
Nolte, E., & McKee, M. (2004). Does Health Care Save Lives? Avoidable Mortality Revisited. London: Nuffield Trust.Google Scholar
Priaulx, J., de Koning, H. J., de Kok, I., Szeles, G., & McKee, M. (2018). Identifying the barriers to effective breast, cervical and colorectal cancer screening in thirty-one European countries using the Barriers to Effective Screening Tool (BEST). Health Policy 122, 1190–1197.Google Scholar
Rawlins, M. D. (2018). The UK’s life sciences strategy: opportunities for clinical pharmacology. British Journal of Clinical Pharmacology 84(10), 2175–2177.Google Scholar
Reeves, A., Gourtsoyannis, Y., Basu, S., et al. (2015). Financing universal health coverage – effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries. Lancet 386, 274–280.Google Scholar
Reeves, A., McKee, M., Basu, S., & Stuckler, D. (2014). The political economy of austerity and healthcare: cross-national analysis of expenditure changes in 27 European nations 1995–2011. Health Policy 115, 1–8.Google Scholar
Reuters (2019). U.S. insulin costs per patient nearly doubled from 2012 to 2016, study finds (online). NBC News. Available at www.nbcnews.com/health/diabetes/u-s-insulin-costs-patient-nearly-doubled-2012–2016-study-n961296 (accessed April 4, 2019).Google Scholar
Rosen, M. (1979). The Sunday Times Thalidomide Case: Contempt of Court and the Freedom of the Press. London: Writers and Scholars Educational Trust in association with the British Institute of Human Rights.Google Scholar
Rutstein, D. D., Berenberg, W., Chalmers, T. C., et al. (1976). Measuring the quality of medical care: a clinical method. New England Journal of Medicine 294, 582–588.Google Scholar
Sala-I-Martin, X., Doppelhofer, G., & Miller, R. I. (2004). Determinants of long-term growth: a Bayesian averaging of classical estimates (BACE) approach. American Economic Review 94, 813–835.Google Scholar
Silber, J. H., Romano, P. S., Rosen, A. K., et al. (2007). Failure-to-rescue: comparing definitions to measure quality of care. Medical Care 45, 918–925.Google Scholar
Suhrcke, M., McKee, M., Sauto Arce, R., et al. (2005). The Contribution of Health to the Economy in the European Union. Brussels: European Commission.Google Scholar
Suhrcke, M., Rocco, L., & McKee, M. (2007). Health: A Vital Investment for Economic Development in Eastern Europe and Central Asia, Copenhagen: WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies.Google Scholar
Szasz, T. S. (1974). The Second Sin. London: Routledge & Kegan Paul.Google Scholar
Thomson, R. P. (2007). Safer Care for the Acutely Ill Patient: Learning from Serious Incidents. London: National Patient Safety Agency.Google Scholar
Viens, A. M., & Littmann, J. (2015). Is antimicrobial resistance a slowly emerging disaster? Public Health Ethics 8, 255–265.Google Scholar
Wanless, D. (2001). Securing Our Future Health: Taking a Long-Term View (Interim Report). London, Her Majesty’s Treasury.Google Scholar
Wilkinson, R., & Pickett, K. (2010). The Spirit Level: Why Equality Is Better for Everyone. London: Penguin Books.Google Scholar
World Bank (2005). Dying Too Young. Washington DC, World Bank.Google Scholar
World Health Organization (WHO) (2008). The Tallinn Charter: Health Systems for Health and Wealth. Copenhagen: WHO Regional Office for Europe.Google Scholar
World Health Organization (WHO) (2016). World Health Statistics 2016: Monitoring Health for the Sustainable Development Goals. Geneva: WHO.Google Scholar
World Health Organization (WHO) (2018). Financial Protection Country Reviews (online). Available at www.euro.who.int/en/media-centre/events/events/2018/06/health-systems-for-prosperity-and-solidarity-leaving-no-one-behind/documents/background-resources/financial-protection-country-reviews (accessed June 27, 2018).Google Scholar

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