Ray Moynihan Livres

Health policy in times of crisis is one of the topics of Health Policy Developments 13 exploring the challenge the crisis has posed to health systems, but also asking whether it has provided an opportunity for reform. While some countries like Estonia drastically reduced their healthcare budgets, others, such as Austria and the United States, have responded with plans to boost public expenditure. Can the crisis provide a window of opportunity for reform? In spite of the global financial crisis, for many, confidence in market mechanisms seems not to have been shaken. One of the key assumptions of contemporary health policy debate remains: more competition will help produce systems where resources are used more efficiently. However, as governments seek to enhance market mechanisms in health systems, successful regulation is needed to facilitate those changes and avoid unintended consequences. To assess the effects of competition and regulation, as well as other reform approaches, systematic analysis is needed. Health policy evaluation, therefore, is another focus of this issue of Health Policy Developments, as well as hospital care and its coordination with other sectors, prevention and health inequalities. The International Network Health Policy and Reform aims to narrow the gap between health services research and health policy. Network partners are research institutions and health policy experts from 20 industrialized countries.

Thirty years ago, the head of the drug company Merck made some remarkably candid comments about his distress that his company's market was limited to sick people. Suggesting he would like Merck to be more like the maker of Wrigley's chewing gum, the CEO said it had long been his dream to make drugs for healthy people, to "sell to everyone." That dream now drives the marketing machinery of the most profitable industry on earth. From award-winning Ray Moynihan, -- one of the world's top medical journalists -- Selling Sickness reveals how widening the boundaries of illness and lowering the threshold for treatments is creating millions of new patients and billions in new profits. This in turn is driving up personal drug bills and threatening to bankrupt national health systems all over the world. As more and more ordinary life is "medicalized," the industry moves ever closer to being able to "sell to everyone."

While care coordination and quality of care remain paramount policy topics everywhere, countries again turn to payment and efficiency challenges. Issue 12 of Health Policy Developments examines how health systems are trying to maximize value for money - exploring new avenues and mixing incentives. Preceding the value question there is a much simpler Where does the money come from? Clearly, someone needs to shoulder the burden of higher healthcare costs, but who should pay for what? Should it be private health insurers or the pharmaceutical industry as is happening in France and Australia, the whole population as it is in Finland or Canada, or should people above a certain body mass index be taxed, as in Alabama? Further topics in this issue are governance in Bismarckian systems, responsiveness of health systems to vulnerable groups, access and equity, and patient safety and quality. The International Network Health Policy and Reform aims to narrow the gap between health services research and health policy. Network partners are research institutions and health policy experts from 20 industrialized countries.