Sholom Glouberman, Director of Canadian Policy Research Networks, May 2001
One characteristic stands out above all in the history of our developing understanding of health, - its complexity. "We now realize that health is shaped by numerous, perhaps countless, forces from many different spheres of influence, ranging from the molecular to the socioeconomic," says Sholom Glouberman, Director of CPRN's Health Network. Glouberman is the author of Towards a New Perspective on Health Policy, the final report of a three-year research project at CPRN. The report ties together a number of separate studies and the results of discussions involving some 3,500 people at more than 90 events held over the course of developing the research conclusions. Judith Maxwell, President of CPRN, says Glouberman's study points to the importance of placing the reform of the health care system in this broader context. "All of us want to feel secure in the knowledge that health care will be there for us should we need it." says Maxwell. "What Sholom's study underlines is that further investment in the health care system should consider how to regain public confidence in it. It is this interactive sense of security that has a significant impact on health along with other factors such as biological condition, social relationships, economic status, work experience and culture."
Public-Private Mix
Paper prepared for WHO’s Commission on Macroeconomics and Health by Adam Wagstaff The World Bank, The University of Sussex, UK
There are three key levels of government action—the macro level, the health system, and the micro level. Government decisions and actions at each level influence the amount households pay for their health care (financing), and the quantity, quality and type of services they receive (delivery). At the macro level, governments decide how much to spend on health care (and related services) and where, and how to raise the revenues to finance them. At the system level, they decide the mode of service delivery and how to regulate the private sector, and how much to charge for different services and how far to exempt the poor from fees. At the micro level, they influence the accountability of providers and the services and interventions they deliver, and how best to implement facility-based revenue collection schemes. There are, in short, many ways that governments can potentially influence both health gaps between the poor and better-off, and the degree to which poor households are affected disproportionately by the costs of health services.