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12. Organ Transplants at Cedar Sinai Medical Center, Los Angeles, and the Third Industrial Revolution
- Author:
- Oenone Kubie, Christopher McKenna, and Steven Yamshon
- Publication Date:
- 08-2017
- Content Type:
- Case Study
- Institution:
- Oxford Centre for Global History
- Abstract:
- Cedars Sinai Hospital does not serve an everyday clientele. Situated in the West Hollywood neighbourhood in Los Angeles, the non-profit hospital caters to the rich and glamourous – a ‘hospital to the stars’. It was there that Madonna received hernia surgery and Frank Sinatra suffered a fatal heart attack. More recently, Kim Kardashian and Kanye West chose the hospital for the birth of their daughter. However, the hospital is famous for more than its celebrity patients. Cedars Sinai has a history of innovation and has often sought to be a world leader of medical research. In 2010, Tom Priselac, the long-time Chief Executive Officer of the Cedars Sinai Health System was presented with the opportunity to add to this history of innovation and establish a prestigious center for heart transplants at Cedars Sinai. To do so would position Cedars Sinai at the forefront of cardiac research. On the other hand, to establish the specialisation would require a huge investment which Priselac might better use elsewhere in the medical center. The decision required Priselac to consider the competitiveness of the hospital within the Los Angeles healthcare landscape, the logic of creating a specialisation, and the future of healthcare within a global economy.
- Topic:
- Health Care Policy, Capitalism, and Global Political Economy
- Political Geography:
- United States, California, and Los Angeles
13. Value and Protection for Domestic Work
- Author:
- Jo Beletic
- Publication Date:
- 05-2017
- Content Type:
- Working Paper
- Institution:
- Center on Human Rights Education, University of Denver
- Abstract:
- The cover story of The Atlantic’s June 2017 issue, “My Family’s Slave”, has flurried around social media over the last couple of weeks. The heart wrenching story sheds light on the enslavement of Eudocia “Lola” Tomas Pulido. If you haven’t already done so, do yourself a favor and click through on the link above to read it. Most stories of this sort do not have such a warm ending. Most stories of this sort are never written. What is most disheartening of Lola’s situation is the fact that her story is more common than many Americans realize. Lolas are hidden in urban centers and tucked away within organized suburbia across the US. Domestic workers—people engaged in an employment relationship for work performed within a household—are vulnerable in their invisibility. In the US, over 2 million individuals are engaged in domestic work. Nannies, housekeepers, and healthcare workers are cooking, cleaning, ironing, caring for children, the sick, and the elderly behind closed doors. Many of these workers, generally women and girls, are immigrant women and women of color. As advocates for improved rights of these workers attest: domestic work makes all other work possible.
- Topic:
- Human Rights, Labor Issues, Health Care Policy, and Labor Rights
- Political Geography:
- United States and North America
14. Paying for Prescription Drugs Around the World: Why Is the U.S. an Outlier?
- Author:
- Shawn Bishop, David Squires, and Dana O. Sarnak
- Publication Date:
- 10-2017
- Content Type:
- Special Report
- Institution:
- The Commonwealth Fund
- Abstract:
- arious factors contribute to high per capita drug spending in the U.S. While drug utilization appears to be similar in the U.S. and the nine other countries considered, the prices at which drugs are sold in the U.S. are substantially higher. These price differences appear to at least partly explain current and historical disparities in spending on pharmaceutical drugs. U.S. consumers face particularly high out-of-pocket costs, both because the U.S. has a large uninsured population and because cost-sharing requirements for those with coverage are more burdensome than in other countries. Most Americans support reducing pharmaceutical costs. International experience demonstrates that policies like universal health coverage, insurance benefit design that restricts out-of-pocket spending, and certain price control strategies, like centralized price negotiations, can be effective.
- Topic:
- Health, Health Care Policy, and Drugs
- Political Geography:
- United States, Europe, and Global Focus
15. Designing a High-Performing Health Care System for Patients with Complex Needs: Ten Recommendations for Policymakers
- Publication Date:
- 09-2017
- Content Type:
- Special Report
- Institution:
- The Commonwealth Fund
- Abstract:
- Health care costs are heavily concentrated among people with multiple health problems. Often, these are older adults living with frailty, advanced illness, or other complex conditions. In 2014, the New York–based Commonwealth Fund, a private, independent foundation, established the International Experts Working Group on Patients with Complex Needs through a grant to the London School of Economics and Political Science. The group’s purpose was to outline the prerequisites of a high-performing health care system for “high-need, high-cost” patients and to identify promising international innovations in health care delivery for meeting needs of these patients. Drawing on international experience, quantitative and qualitative evidence, and its members’ collective expertise in policy and program design, implementation, and evaluation, the international working group sought to articulate the principles that underpin high performance for this complex population in health systems around the world.
- Topic:
- Health and Health Care Policy
- Political Geography:
- United States and Global Focus
16. Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities fo
- Author:
- Michelle M. Doty, Arnav Shah, David Squires, Dana O. Sarnak, and Eric C. Schneider
- Publication Date:
- 07-2017
- Content Type:
- Special Report
- Institution:
- The Commonwealth Fund
- Abstract:
- The U.S. ranked last on performance overall, and ranked last or near last on the Access, Administrative Efficiency, Equity, and Health Care Outcomes domains. The top-ranked countries overall were the U.K., Australia, and the Netherlands. Based on a broad range of indicators, the U.S. health system is an outlier, spending far more but falling short of the performance achieved by other high-income countries. The results suggest the U.S. health care system should look at other countries’ approaches if it wants to achieve an affordable high-performing health care system that serves all Americans.
- Topic:
- Health and Health Care Policy
- Political Geography:
- United States and Global Focus
17. International Profiles of Health Care Systems
- Author:
- Elias Mossialos, Ana Djordjevic, Robin Osborn, and Dana O. Sarnak
- Publication Date:
- 05-2017
- Content Type:
- Special Report
- Institution:
- The Commonwealth Fund
- Abstract:
- This publication presents overviews of the health care systems of Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, Taiwan, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.
- Topic:
- Health and Health Care Policy
- Political Geography:
- United States and Global Focus
18. How High-Need Patients Experience the Health Care System in Nine Countries
- Author:
- Dana O. Sarnak and Jamie Ryan
- Publication Date:
- 01-2016
- Content Type:
- Special Report
- Institution:
- The Commonwealth Fund
- Abstract:
- U.S. health care costs are disproportionately concentrated among older adults with multiple chronic conditions or functional limitations—a population often referred to as “high-need” patients. This analysis uses data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults to investigate health care use, quality, and experiences among high-need patients in nine countries compared with other older adults. High-need patients use a greater amount of health care services and also experience more coordination problems and financial barriers to care compared with other older adults. Disparities are particularly pronounced in the United States. The comparative success of other countries, particularly in reducing financial barriers to care, may be a product of policies that specifically target high-need patients. Similarly focusing on these populations in the U.S. and effectively managing their care may improve their health status while reducing overall costs.
- Topic:
- Health and Health Care Policy
- Political Geography:
- United States and Global Focus
19. Equatorial Guinea Plays a Leading Role in Combating Malaria
- Author:
- Mark L. Asquino
- Publication Date:
- 09-2015
- Content Type:
- Journal Article
- Journal:
- The Ambassador's Review
- Abstract:
- In August 2014, I attended a ceremony at the Willard Hotel in Washington, DC that celebrated the tenth anniversary of the Bioko Island Malaria Control Project. Those speaking at the event included senior executives from Marathon Oil Corporation, Noble Energy Inc., and Atlantic Methanol Production Company, which are all US petroleum companies that operate in Equatorial Guinea. Teodoro Obiang Nguema Mbasogo, President of Equatorial Guinea, also delivered remarks. All of the speakers were enthusiastic about a dynamic project that has had a transformative effect on the health of generations of Equatoguineans by reducing the morbidity and mortality of malaria infection. What follows is an overview of the project’s history as well as the commitment to US innovation and a shared audacity to tackle one of humankind’s most endemic and fatal diseases.
- Topic:
- Development, Health, Human Welfare, Infectious Diseases, and Health Care Policy
- Political Geography:
- United States and Equatorial Guinea
20. Antimicrobial Resistance as an Emerging Threat to National Security
- Author:
- Maxine Builder
- Publication Date:
- 01-2015
- Content Type:
- Working Paper
- Institution:
- Atlantic Council
- Abstract:
- Growing rates of antimicrobial resistance (AMR) pose a threat to public health that could undo many of the medical advances made over the last seventy years, eroding the global medical safety net and posing a significant threat to national security. Diseases once eliminated by a single course of antibiotics show drug resistance, often to several different classes of drugs. Some of the implications of increasing rates of AMR are intuitive, such as longer duration of illness, extended hospital stays, and higher rates of mortality. But other effects of a postantibiotics world are less obvious, such as the inability to perform life-saving operations or the ability for a simple scratch on the arm to kill. Humanity could soon find itself living in a reality in which communicable diseases such as tuberculosis, cholera, pneumonia, and other common infections cannot be controlled. This potentially catastrophic problem still can be abated, and the global health community, including the World Health Organization (WHO), has highlighted AMR as a priority in global health. But all sectors of the international community, not simply those in public health, need to take immediate steps to reverse the current trends and eliminate the systematic misuse of antimicrobial drugs, especially in livestock, and restore the pipeline of new antimicrobial drugs. The significant health and economic costs of AMR are difficult to quantify due to incomplete data that often underreports the extent of the problem, since there are no standard metrics or consensus on methodology to measure rates of AMR. But even the piecemeal statistics that exist paint a bleak picture. In a 2013 report, the US Centers for Disease Control and Prevention (CDC) reports at least two million Americans acquire serious infections to one or more strains of AMR bacteria annually, and at least 23,000 people die of these infections.1 A 2008 study estimated the excess direct costs to the US medical system attributable to AMR infections at $20 billion, with additional estimated productivity losses to be as high as $35 billion.2 With the increase in resistant infections and continuing rise in medical costs, the cost to the American medical system no doubt also has increased. This trend is not a uniquely American problem; it is truly global in scope. The European Union (EU) reports about 25,000 deaths annually due to drug-resistant bacteria, at an overall, combined cost of $2 billion in healthcare costs and productivity losses.3 There were over 14.7 million incidents of moderate-to-severe adverse reactions to antibiotics each year between 2001 and 2005 in China. Of these, 150,000 patients died annually.4 The most recent available data on China estimates that treatment of AMR infections during that same time period cost at least $477 million, with productivity losses of more than $55 million each year.5 A 2005 study of the United Kingdom (UK) found that the real annual gross domestic losses due to AMR were between 0.4 and 1.6 percent.6 Although slightly outdated, this estimate may be a useful guide in assessing the global impact of AMR, and given the trend of increasing resistance, it is likely that the impact will also increase accordingly. That said, it is prudent to repeat that the disparities in the quality of data reporting standards across China, the United States, the United Kingdom, and the European Union make it difficult to directly compare the severity of the impacts AMR has on each entity. The primary cause of AMR globally is antibiotic overuse and misuse, be it from doctors inappropriately prescribing antibiotics to treat viral infections or individuals seeking over-the-counter antibiotics for self-treatment. But another driver, less obvious than overuse in humans, is the use of antimicrobials in livestock, and the ratio of use in animals as compared to humans is astounding. In the United States, about 80 percent of all antibiotics are consumed in either agriculture or aquaculture. Generally, these drugs are administered to livestock as growth promoters and are medically unnecessary. Resistance in livestock quickly spreads to humans, and many community-acquired infections are the result of a contaminated food supply. Although most infections are acquired in the community, most deaths attributed to resistant infections occur in healthcare settings, and healthcare-acquired (or nosocomial) infections are another driver of AMR. At this point, AMR does not pose an immediate and direct threat to national security. Rather, this is a creeping global security crisis. If current trends continue, these drugs upon which the world relies will lose effectiveness. The gains made in fighting infectious diseases will be reversed, and a wide range of routine surgeries and easily treatable infections will become much more dangerous and deadly. This will cause the health of the world's working population to deteriorate, and the economic productivity and social cohesion of the globe to decline. At any time, a “black swan” event—triggered by an outbreak of drug-resistant tuberculosis, cholera, or pneumonia, for example—could prove catastrophic, endangering the fabric of societies and our globalized economy, forcing a stop to international trade and travel to prevent further spread. The issue of AMR is a tragedy of the commons in which individual incentives lead to the overuse and eventual destruction of a shared resource. International cooperation is required to walk back from this ledge and avoid a postantibiotics world, even though it is impossible to completely reverse the damage already done.
- Topic:
- Health, National Security, Infectious Diseases, and Health Care Policy
- Political Geography:
- United States, China, United Kingdom, America, and Europe
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