Search results

Health care has become one of the paramount issues of the 21st century as governments and individuals grapple the complex problems associated with contemporary medical care such as cost, affordability, and shifting demographic trends. One response has been the growth of medical tourism (sometimes called health tourism or global healthcare). Medical tourism is an example of how the forces of globalization are re-shaping what has previously been a relatively stable localized service, medical treatment, in the face of changes to health care. While traveling to distant locations in search of health restoring locations is not new as the affluent have long traveled to spas or exotic locales to derive health benefits. What has changed is who is doing it and why they are doing it as insurers and patients alike become eager participants in the outsourcing of medical care. The rising number of uninsured and underinsured Americans, particularly in the middle class, has been coupled with effective marketing by medical tourism companies to produce growing numbers of Americans traveling to foreign countries for healthcare. China, India, Korea, Malaysia, the Philippines, South Africa, and Thailand are only a few of the competitors for overseas patients as a source for economic development. Using analytic frameworks of Immanuel Wallerstein and Anthony Giddens to provide a social analysis of this phenomenon yields an exploration of this trend.

Health care systems all over the world are undergoing rapid and profound transformations. These changes are the result of a broad array of economic and social trends including neo-liberal economic policies that are contributing to the trend toward privatization, the commodification of health services and products, institutional restructuring (e.g., managed care) to contain costs in the context of technological advances, globalization and demographic changes such as population aging in post-industrial societies. Questions about the accessibility and quality of health care delivery in the face of persistent health disparities, growing numbers of medical errors, and new and uncertain risks posed by emerging infectious diseases, some of them drug-resistant, have also contributed to rethinking about health policy.

Recent invasions, coups, civil wars, and ethnic crusades have caused many individuals and families around the world to flee their homelands for fear of their own safety. The exodus of refugees to foreign nations causes a strain on those nations’ health care systems and resources. With the assistance of outside organizations, these countries can develop a health care management system for refugees that provides for both their immediate survival and long-term health stability, while preserving critical national resources. This chapter reviews the refugee problem and presents the short-term tactics and long-term strategies undertaken by seven very different national governments to care for the refugees that cross their borders. A model of a sound health care management system is used to incorporate the best practices of each country into a framework for approaching this multi-billion dollar issue.

As both concept and process, privatization possesses ambiguous connotations and multiple meanings. Webster's Dictionary (1981) defines one related noun, privatism, as “an attitude of uncommitment or uninvolvement in anything beyond one's immediate interests,” while another associated noun, privacy, denotes a state of “withdrawal from society or the public interest” (Oxford English Dictionary, 1972). If government is a means of providing a wide range of collective goods, which do not necessarily lend themselves to market exchange, the public sector is naturally a highly visible target.⁴ At the same time, unrestrained public-sector expansion inevitably leads to public policy failure, as problems of communication, coordination, effective cost–benefit control, and revenue satiation accumulate.⁵ Privatization represents a logical reaction.

This chapter considers how mental health care is done in and by digital culture in the UK. The author examines how treatments for anxiety and depression operate in today’s technosocial age of smartphone hegemony. Smartphones, the author argues, offer valuable insight into contemporary health and wellbeing precisely because they are emblematic of the neoliberal production logics, knowledge claims and modes of address that structure this moment in digital culture history. The author also shows how this moment is the outcome of key shifts in computing hardware, software, and content. Empirically, this research focusses on mapping Britain’s terrain of smartphone interventions for anxiety and depression. Working from a dataset of 635 apps, the author develops a four-part framework for understanding products and services in this crowded marketplace relative to an app’s (1) intended audience; (2) communicative affordances; (3) business model; and (4) therapeutic approach. Through this framework, the author proposes the notion of me apps to codify the individualised, commercialised, and desocialised mode of address enacted by most of the apps in the dataset. The author shows that the ideology of me apps, and the modes of address they employ, frame mental illness as an individual problem and regard treatment as an individual endeavour. The end of the chapter considers the possibility of an alternative vision for designing technologies of mental wellbeing.

Purpose – For much of the first half of 2003 world attention was captured by news of a mysterious but deadly virus that was claiming lives in places as distant as Toronto and Beijing. In a matter of months there were around 8,000 infections and over 689 deaths related to severe acute respiratory syndrome (SARS). In my hometown, Toronto, 43 people died of SARS during the outbreaks of 2003.

Approach – This chapter examines issues of class and poverty in emergence of SARS. The chapter begins with a discussion of the political economy of the emergence of SARS, and its relation to the spread of the virus. It then discusses issues of public policy, and particularly neo-liberal cuts to social services and public spending, that set the stage for the SARS outbreak, influenced its impact and contributed to the failures of response in Ontario.

Findings – Through analysis of the lack of social resources available to working people in the province and the prioritizing of corporate, particularly tourism industry, concerns, the chapter illustrates how issues of class underpinned public responses to SARS, exacerbating problems. The chapter concludes by giving attention to the need for social solidarity and community mutual aid.

Contributions to the field – The chapter shows the extent to which neo-liberal governments prioritize business security above the health and social security of workers and reveals some of the ways in which the pressures of capitalist social relations make people ill.

Purpose – This chapter assesses the role of self-help groups within the emerging civil society in two transitional economies, Croatia and Slovenia, focusing on the impact of relationships with health or social care professionals and the state.

Methodology – Methods include participant observation, interviews, and document analysis of 31 groups studied intermittently from 2001 to 2007.

Findings – Self-help groups range from those three decades old to those dealing with “new social problems.” Groups, and the third sector generally, remain essentially dependent on the state. Few exist separately from formal service organizations. Those closely linked with medical institutions are challenged by state retrenchment and privatization. Others contend with funding instability, and Western models of non-profit development are expanding. Relationships with professionals are neither subservient nor independent; instead, groups act as corollaries and educators to the professional realm.

Implications, limitations, and value – Findings suggest more nuances in self-help groups' relations with the state and professionals than found in Western settings. This may illustrate both the potential and the limits of citizen involvement in new non-governmental sectors. It also demonstrates how relations between professionals and self-help groups depend on social and material relations well beyond the domain of systems of care. While specific findings cannot be generalized beyond the research settings, the study shows the importance of understanding such groups within social and political contexts. Contributions to civil society here included re-making public meanings, identities, and relations with professionalized systems. Further comparative assessment of self-help associations is essential to theory on the third sector in civil society.

No other region of the world has suffered from such devastating epidemics in the recent past than sub-Saharan Africa. HIV/AIDS poses the worst single health threat on the continent and approximately 28.5 million of people infected with HIV/AIDS are in sub-Saharan Africa, yet, less than 8% have access to treatment. As African countries start or continue to expand their HIV/AIDS treatment programs with the assistance of international donors, they are facing several ethical and health policy challenges, including difficult decisions on how to ration available treatment, the high cost of drugs, the complexity of treatment regimens, the inadequacy of health and delivery systems, the lack of knowledge about treatment, and the threat of drug resistance.

Canada's institutions, by comparison with America's, have created a unique normative regime. When it comes to conflict of interest, the main problem in Canada has not been that private interests encumber governmental judgment, but that government itself, and in particular the publicly sourced emoluments controlled by the prime minister, can encumber the judgment of ministers and legislators. When it comes to campaign finance law, the problem is that parties are treated as if they are self-interested entities, while interest groups have often been treated as if they are parties. I explore the institutional causes and regulatory consequences of Canada's unique normative approach.

Public hospitals have long been major players in the US health care delivery system. However, many public hospitals have privatized during the past few decades. The purpose of this chapter was to investigate the impact of public hospitals' privatization on community orientation (CO). This longitudinal study used a national sample of nonfederal acute-care public hospitals (1997–2010). Negative binomial regression models with hospital-level and year fixed effects were used to estimate the relationships. Our findings suggested that privatization was associated with a 14% increase in the number of CO activities, on average, compared with the number of CO activities prior to privatization. Public hospitals privatizing to for-profit status exhibited a 29% increase in the number of CO activities, relative to an insignificant 9% increase for public hospitals privatizing to not-for-profit status.