Chapter 3

Question 1

To regulate the quantity and distribution of services, the state has….

Answer 1

• licensed providers and facilities
• Controls the number and sizes of medical schools, number of doctors in areas, introduction of high technology
• provided incentives for health practitioners in rural areas

Question 2

To regulate prices of services government has..

Answer 2

• negotiated salary scales
• set charges
• negotiated reimbursement rates

Question 3

To regulate quality of health services, governments have…

Answer 3

• licensed practitioners
• registered and accredited facilities
• required providers to establish complaints procedures
• required provision of information for monitoring quality
• controlled training curricula
• set requirements for continuing education

Question 4

Public health functions do…

Answer 4

• ensure safe water and food purity
• establish quarantine and border control measures to curb the spread of infectious diseases
• regulate roads and workplaces to reduce the threat of injuries
• legislate curb environmental and noise pollution
• set standards for food labeling, the level of lead in petrol and tar and nicotine in cigarettes
• regulate and license industries as well as oblige them to adopt different technologies on public health grounds.

Question 5

How does the state get money from private companies and citizens?

Answer 5

By tax

Question 6

What do the consumers get in return of the goverment for their tax.

Answer 6

Services and goods.

Question 7

What are the problems of Health system reform

Answer 7

• Technological developments increase costs and make choices necessary
• rise in chronic diseases put pressure on services
• demographic developments

Question 8

What are the basic pillars of the fundamental health system

Answer 8

Affordable
Accessible
Acceptable
Appropriate

Question 9

What is the reason that the basic pillars does not fit the health system anymore

Answer 9

• ageing population
• changing society
• over medication

Question 10

How is overmedicalistion arised

Answer 10

pharmaceuticals are private companies and get money for medicine they sell

Question 11

what is the current idealogy

Answer 11

Slimmed down state through decentralization & increased private sector roll

Question 12

Market pressures for public services - new public management:

Answer 12

• Competition for contracts from public purchasers

- Competitive tendering (several industries) of support services

Question 13

New financial mechanisms:

Answer 13

Introduction of out-of-pocket fees for service use

Question 14

Decentralization

Answer 14

Functions of MoH –> executive agencies
Authority of MoH –> district or local levels
Autonomy for hospitals
- increased rol of private sector.

Question 15

What is the Influence on public health policy of this private sector roll

Answer 15

-Financial support of political parties and campaigns (money)
-participation in governmental committees and working groups (knowledge)
-establishment of sectional interest group of joint companies (power)
-establishment of industry funded think tanks
-financial support to research organizations
-Establishment of scientific organizations
-financial support to patient organizations
-PR firms for media
This is called lobbying

Question 16

Private sector & norms

Answer 16

Self regulation - substitutes public policy:
Market standards: facilitate trade
Social standards

Question 17

Types of social standards

Answer 17

• corporate social responsibility
• voluntary codes and reporting initiatives
• corporate philanthropic programmes

Question 18

Why are they doing that?

Answer 18

• Concerns raised by consumer and stakeholders

- threat of public regulation

Question 19

Doubts about the social standards?

Answer 19

• lack of transparency and accountability - no involvement of public in M&E
• Lack of timely and effective sanctions
• Erodes Universal rights
• Only concerns selected issues and groups of workers

Question 20

Public-private partnerships (new relationships)?

Answer 20

Co regulation: public and private sectors negotiate on an agreed set of policy or regulatory objective - private sector implements
-joint planning and funding of health programmes - private sector implements