"A ground breaking set of case studies about how [health care] coverage decisions are made" Robert A. Berenson M.D. Senior Fellow at the Urban Institute, Washington D.C. and former Director of the Center for Health Plans and Providers of the Medicare program Developed countries are facing rapidly rising health care costs and one of the major factors driving health care cost growth is the continual development and diffusion of new, generally more expensive, health care technologies. This book contains: * A description of the institutions, procedures and criteria used by eight countries for assessing technologies for public insurance coverage * An analysis of the role of interest groups, and of the public interest, in these decision making processes * An examination of how particular technologies are treated differently by different countries, and why Based upon research from Australia, Canada, Germany, The Netherlands, Spain, Switzerland, the United States of America and the United Kingdom, the contributors argue that although each of these countries is committed to evidence-based scientific assessment of technologies, in fact adoption of technologies is significantly affected by political considerations, and in particular by the influence of interest groups. Moreover, it offers recommendations as to how technology assessment for coverage policy can be improved to serve better the public interest. Health Care Coverage Determinations is essential reading for health policy makers, managers, researchers and students with an interest in health economics, health care provision and the politics affecting health care legislation. Contributors: Liliana Bulfone, Tanisha Carino, Peter C. Coyte, Anna García-Altés, Colleen M. Flood, Stefan Greß, Felix Gurtner, Anthony Harris, Timothy Stoltzfus Jost, Eric Nauenberg, Christopher Newdick, Dea Niebuhr, Guillaume Roduit, Heinz Rothgang, Frans F.H. Rutten, Dominique Sprumont, Juergen Wasem.

Health Insurance Systems: An International Comparison offers united and synthesized information currently available only in scattered locations - if at all - to students, researchers, and policymakers. The book provides helpful contexts, so people worldwide can understand various healthcare systems. By using it as a guide to the mechanics of different healthcare systems, readers can examine existing systems as frameworks for developing their own. Case examples of countries adopting insurance characteristics from other countries enhance the critical insights offered in the book. If more information about health insurance alternatives can lead to better decisions, this guide can provide an essential service. Delivers fundamental insights into the different ways that countries organize their health insurance systems Presents ten prominent health insurance systems in one book, facilitating comparisons and contrasts, to help draw policy lessons Countries included are Australia, Canada, France, Germany, Japan, the Netherlands, Sweden, Switzerland, the United Kingdom, and the United States Helps students, researchers, and policymakers searching for innovative designs by providing cases describing what countries have learned from each other

"Dr. Gauld’s collection of case studies is informativeand accessible. I would recommend it as acentral text for a course in comparative healthsystems." Political Studies Review Based upon research from eight countries in the Asia-Pacific – Australia, China, Hong Kong, Japan, New Zealand, Singapore, South Korea, Taiwan – this book analyses and compares their differing health policies. Key issues the book probes include: ·The ways that health care is financed and delivered across the region ·The historical and institutional arrangements that impact upon health policy and health care ·How the health systems differ between the countries under study ·How policymakers and service providers deal with unlimited demand and limited funding and issues such as service coverage and quality ·How pharmaceuticals and population health strategies are managed ·What the roles of the state and various other players (such as the private sector and professional associations) are in the making of health policy and delivery of health care ·The challenges that lie ahead for health care and health policy in the region Comparative Health Policy in the Asia-Pacific is key reading for students, researchers and policy makers with an interest in health policy. It is relevant to those studying medicine and health studies, anthropology, history, sociology, public policy, politics and Asian studies.

"This is an excellent and accessible introduction to key current debates in health policy. It is enriched by deft comparative analysis and by the way Dr Gauld locates the study in the context of current ideological debates. Students will learn a lot from wrestling with the questions posed at the end of each chapter – and so will their teachers!" Paul Wilding, Emeritus Professor of Social Policy, University of Manchester, UK This book analyzes the issues that form the nucleus of the emerging ‘new health policy’ agenda. Robin Gauld brings together in one volume a comprehensive picture of the health policy challenges facing contemporary developed world health systems, as well as the strategies for tackling these. Individual chapters, respectively, analyze: Challenges in health care funding and organization Quality and patient safety The application of information technology Clinical governance The changing nature of professionalism and public involvement in health care planning Public health The role of the private sector The book highlights the importance to policy makers of each subject, overviews research into it, and discusses policy responses in Britain, New Zealand and the United States. The New Health Policy is essential reading for all students of health policy and health care, along with policy makers and health care professionals.

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages -- cancer and cardiovascular disease -- available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which -- unlike randomized controlled trials -- are subject to many biases.