Two options of international aid and health policy, summary of general introduction lecture of Professor JP Unger

                 This sub-CC1 talk about the suitable approach or policy to deal with health care that should be social health care more than commercial health care as these topics following; <ol>

  • ICHD values: Quality Standards for publicly oriented Health Services
  • Criticism 1 International policies, PHC, DC, & integration
  • Criticism 2Evidences for international health policies
  • Policy & politics
  • Development & globalization Health, development, & globalization
  • Motivation Hannah Arendt, Aristotle, & motivation

    • </ol><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">Summary of this component: </p><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">                 The EU doctrine is neoliberal policies that failed to control disease in Developing country. It does not allow co-existence of and competition between a public sector and the private sector for services for which there is a demand in the market. It attempts to maximize public funds’ transfer towards private sector (supposedly more efficient).</p><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">                  A negative feedback loop; neoliberal policies allocate patients to private sector and disease control to public and disease control programs nevertheless contributed to limit access to health care in public services by polarizing them according to their interests.</p><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">                 Modern primary health care (PMC) should promote health care/disease control integration. Health care responds to people’s demand for suffering alleviation (condition for community participation and for effective, efficient disease control). Modern PMC should promote not-for profit, publicly oriented health services with a social rational. International cooperation should finance it instead of mere disease control.</p><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">                The results of implementation Health policy in Colombia and Chile are different from Costa Rica that implemented the different policy. The Outcomes of health policy in Costa Rica is dominantly better than in Colombia and Chile that paradoxical increase in insurance coverage and reduction in access to care. So private sectors couldn’t substitute evanescent public service in developing countries because of failure in implementation (lesser than 50 % of public expenditure on health care comparing with total expenditure on health care) and failure to deliver (lack of control/regulation of social pluralism in government & administration).</p><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">                    The policy implemented in Colombia & Chile is called Dominant (Neoliberal) international aid policy. This policy promoted heath care in private sector and disease control by MOH. The policy features are as Political, fiscal & administrative decentralization; general health system of social health security; purchaser-provider split, contracting-out health care; contributory system for those who can afford it: complete package of health interventions; subsidized regime would cover the rest of population; health care delivery institutions & autonomous former public services contracted by insurances; health care& financing institutions could be public, private or mixed & for-or-not profit.</p><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">                   The policy implemented in Costa Rica is called Social-and-Democrat international aid policy. This policy promoted the integration of health care & disease control in publicly oriented health services and remained health care of private for profit. The policy features are unified public system allowing integration; publicly oriented services as dominant, though non monopoly, delivery institutions of care; contracting in; user & communities’ participation in health services management; government expenditure represent the bulk of total expenditure; no real purchaser-provider split, nor hospital managerial autonomy; a single public insurer (no private insurance).</p><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">                  Scope for improvement in Costa Rica are developing bio-psychosocial care in health centers, promoting non-managed care techniques to improve quality of care, strengthen co-management of health services and setting up local health systems.</p><p style="margin: 0cm 0cm 0pt" class="MsoNoSpacing">            “No social pluralism in government equal definition of developing country.” JP Unger</p> Phichet Banyati,November 10, 2007.Antwerp