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1. The Political Process Involved in Formulating Healthcare Policy in Japan: With a Particular Focus on Advisory Councils, Interest Groups and Medical Officers

Author:
Yukio Sakurai
Publication Date:
01-2025
Content Type:
Journal Article
Journal:
The Rest: Journal of Politics and Development
Institution:
Centre for Strategic Research and Analysis (CESRAN)
Abstract:
Japan’s healthcare policy is defined by a universal health insurance system that guarantees affordable healthcare for all citizens at any time and in any location. The system was established in 1961 and has since undergone a process of evolution through the implementation of national healthcare policies. Despite the existence of conflicts and issues, the mechanism of the Central Social Insurance Medical Council (“Chuikyo”) has continued to advance national healthcare interests. Nevertheless, this resulted in the commencement of criminal proceedings in 2004. The current demographic shifts present a challenge to the long-term sustainability of the national health insurance system, the long-term care insurance system, and the public pension system. This is occurring against a backdrop of rising costs associated with healthcare and long-term care, as well as an unsustainable national budget. The Chuikyo system is confronted with a multitude of challenges. This paper analyses the roles of three key actors in the Japanese national healthcare policy-making process. These actors include advisory councils such as Chuikyo, interest groups such as the Japan Medical Agency, and medical officers of the Ministry of Health, Labour and Welfare, who play a pivotal role in the policy-making process. The incremental improvements that Chuikyo produces are insufficient to address the long-term challenges facing the national healthcare policy. Japan’s healthcare model requires reconstruction to align it with the needs of an ageing society with a declining birthrate. Prior to embarking on this important policy work, it is essential to determine who should lead it. It is recommended that the Prime Minister and the Cabinet Office spearhead a study on radical reform, with strong political leadership and a capable technocrat team to facilitate collaboration with the National Diet and the public. Furthermore, it would be crucial to achieve a consensus through national forums on the fundamental concepts that citizens, as consumers, desire and are prepared to forego from a bottom-up approach. It is essential that the governance structure of the national healthcare system is changed to a decentralised structure so that citizens can be proactively involved in healthcare issues and make autonomous decisions.
Topic:
Politics, Insurance, and Healthcare System
Political Geography:
Japan and Asia

2. Strengthening Health System Response to Sexual Violence in Afghanistan

Author:
Barbara Buckinx, Charu Lata Hogg, and Ila Prabhuram
Publication Date:
01-2025
Content Type:
Policy Brief
Institution:
Liechtenstein Institute on Self-Determination, Princeton University
Abstract:
This policy report summarizes insights from a workshop organized by the Liechtenstein Institute on Self-Determination (LISD) at Princeton University on November 5, 2024. The workshop, titled “Strengthening Health System Response to Sexual Violence in Afghanistan,” was co-organized by All Survivors Project (ASP) and cosponsored by the SPIA Afghanistan Policy Lab and the Center for Health and Wellbeing, and was held under the Chatham House Rule.
Topic:
Women, Sexual Violence, Public Health, and Healthcare System
Political Geography:
Afghanistan and South Asia

3. China’s Anti-Corruption Efforts Gain Momentum in Finance and Healthcare

Author:
Alexis Brown
Publication Date:
10-2024
Content Type:
Journal Article
Journal:
China Brief
Institution:
The Jamestown Foundation
Abstract:
On September 27, Chinese President Xi Jinping presided over a meeting of the Politburo, where he announced the end of the current round of finance inspections but suggested that more were to follow (Xinhua, September 27). The authorities may have chosen to focus on financial corruption to coincide with the restructuring of financial regulators in March, in which a central finance commission was created to give the Party center more direct control over the finance sector. This move indicates that the Party has taken a greater interest in the sector. So far in 2023, China’s anti-corruption organs, the Central Commission for Discipline Inspection (CCDI, 中国共产党中央纪律检查委员会) and the National Supervisory Commission (NSC, 中华人民共和国国家监察委员会), have intensified investigations across both the healthcare and finance sectors. Authorities have investigated at least 180 hospital chiefs and 80 senior employees in financial institutions between January and early September. [1] By comparison, the CCDI and NSC only targeted 12 hospital leaders from 2019-2022 (CCDI). Through the anti-corruption campaigns, the party leadership is likely to bolster support among certain demographics, eliminate political opponents, and address some real instances of graft. However, due to the absence of robust institutions and transparency, systemic corruption will persist after the current drives wind down. The Party and state organs carry out anti-corruption in healthcare regularly, but in 2023 they have elevated the importance of this work. This is the first time the CCDI and NSC were involved in the National Health Commission’s annual conference on anti-corruption, where a national centralized campaign to crack down on graft was launched. The campaign will continue until mid-2024 (National Health Commission, July 21). [2] One motivation may be to address public frustrations with healthcare from the COVID-19 pandemic. There was an uproar over incidents like hospitals turning away ER patients for not having negative Covid tests and testing centers generating huge profits but producing fraudulent test results (Joint Prevention and Control Mechanism of the State Council, December 9 2022 Credit China, December 23 2022). Another reason may be to combat illegal healthcare charges in order to boost household consumption, one of the government’s top economic targets for 2023 (Xinhua, March 14).
Topic:
Corruption, Finance, Public Policy, and Healthcare System
Political Geography:
China and Asia

4. Health for the Europeans, who cares?

Author:
Tiphaine Maloingne
Publication Date:
04-2024
Content Type:
Working Paper
Institution:
Robert Schuman Foundation (RSF)
Abstract:
The European Union adapts, moves with the times, and evolves. It is these small steps, often made in response to events, that help the European Union to move forward and create the "common narrative" that has kept it solid for 74 years. For several years now, the EU has been working to strengthen its health policy. In other words, the European Union is gradually building a new common narrative: European health. But in the gradual creation of this policy, what place is given to European citizens and their health? Through considerations that are at once temporal, justificatory, technical and imaginary, this paper offers readers an overview of the contours of a new health system for Europeans.
Topic:
Health, European Union, Citizenship, and Healthcare System
Political Geography:
Europe

5. The Ongoing Genocide in Gaza

Author:
John Cherian
Publication Date:
01-2024
Content Type:
Special Report
Institution:
India International Centre (IIC)
Abstract:
There seems to be no end in sight to the genocidal war being waged in the Gaza Strip. As the new year dawned, more than 22,835 Gazans, the majority of them children and women, have been killed by the Israeli Occupation Forces (IOF).1 The true mortality rates are, of course, much higher as at least 7,000 Palestinians remain buried under the rubble.2 In three months of fighting, one out of every 10 persons living in Gaza has been killed. As international humanitarian organisations and local eyewitness accounts have testified, the Gaza civilians were intentionally targeted by the Israeli military. The deaths of civilians and the damage to civilian infrastructure were not due to collateral damage in the fight between Israel and the Palestine militias in Gaza. After the 7 October 2023 Hamas military attack along the highly fortified border with Israel that had resulted in the deaths of 1,200 residents, Israeli leaders and top army generals had publicly vowed to hit the people of Gaza ‘with fire and brimstone’, quoting Old Testament prophets. It was the worst humiliation the Israeli army had suffered in more than 50 years. There were open calls to ‘ethnically cleanse’ Gaza and the rest of the occupied territories so that Israel could realise its long-held dream of an ‘Eretz Israel’ (Land of Israel) extending from the Red Sea to the Mediterranean Sea. Israel’s Prime Minister, Benjamin Netanyahu, addressing the Israeli parliament shortly after the bloody onslaught on Gaza began, promised to fulfil ‘the prophecy of Isaiah’. The prophecy, a part of the Bible’s ‘Book of Isaiah’, speaks about the creation of a Greater Israel extending from the Nile River to the Euphrates River. In a later speech, Netanyahu said that Israel was on ‘a holy mission’ in Gaza while invoking another Old Testament story of Amalek. According to the Hebrew Bible, the kingdom of Amalek was the arch-enemy of the Israelites. Amalek was the grandson of Esau, the eldest son of Isaac. Esau is believed to be the father of Edomites, a Semitic tribe often in conflict with the Jews. According to the biblical story, God had ordered his ‘chosen people’, the Israelites, to completely obliterate the Amalekites. No Western leader condemned this blatantly ‘genocidal’ statement by the Israeli Prime Minister. Juan Cole, an American academic and expert on West Asian politics, has charged the Netanyahu government of declaring ‘a holy war of annihilation of civilians in Gaza’.3 The Israeli President, Isaac Herzog, had earlier asserted that there were ‘no innocent civilians’ in Gaza. The Israeli Defence Minister, Yoav Gallant, vowed to ‘eliminate everything’ in Gaza. The Israeli government’s ‘genocidal intent’ has become even more evident after three months of war. The number of people killed in the war on Gaza has exceeded the casualty figures of three previous major Arab–Israeli wars. In 1948, the year Israel was recognised as an independent state, around 15,000 Palestinians were killed as they were forcibly dislocated from their ancestral land. More than 20,000 people were killed when Israel invaded Lebanon to remove the Palestine Liberation Organization (PLO) under the leadership of Yasser Arafat from the country.
Topic:
Foreign Policy, Genocide, Atrocities, Hamas, Benjamin Netanyahu, Armed Conflict, and Healthcare System
Political Geography:
Middle East, India, Israel, Palestine, and Gaza

6. The Partograph: A Tool to Reduce Mother-Child Mortality Rate During Labour

Author:
Fobella Nkengafac, Regina Sinsai, Ghyslaine Bruna Djeunang Dongho, Solange Dabou, Evrard Kepgang, and Ronald Gobina
Publication Date:
11-2024
Content Type:
Working Paper
Institution:
The Nkafu Policy Institute
Abstract:
The Safe motherhood initiative is a fundamental aspect of healthcare that was launched in 1987 with an aim to reduce maternal mortality and ensure positive birth outcomes in developing countries(1) [1]. In many parts of the world, women face numerous challenges during childbirth. As a result, maternal and child mortality remains a global concern as the rates continue to remain high with more than 69% of maternal deaths occurring in African countries with rates ranging between 500 and 999 deaths per 100 000 live births (2) [2]. These elevated rates of maternal mortality are generally attributed to complications that arise, during pregnancy, before birth, during birth or after birth, and are commonly avoidable through appropriate interventions. WHO set as part of the 2030 Sustainable Development Goals (SDG), to reduce maternal deaths to 70 maternal deaths per 100 000 live births (1) [1]. Despite significant progress in healthcare, complications during labour and delivery continue to contribute to a substantial number of preventable deaths. The partograph, a simple yet effective tool, has shown promising results in reducing these mortality rates during labour. Yet, its use remains relatively low in some medical facilities in Cameroon (2,3) [2,3]. This article aims to shed light on the importance of the partograph, its role in improving maternal and child health outcomes and highlights its role in reducing complications during labour.
Topic:
Women, Public Health, Healthcare System, and Infant Mortality
Political Geography:
Africa and Cameroon

7. Health Care for Women: How the U.S. Compares Internationally

Author:
Munira Z. Gunja, Relebohile Masitha, and Laurie Zephyrin
Publication Date:
08-2024
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
Recently released federal data once again show the United States with by far the highest rate of maternal deaths of any high-income nation, despite a decline since the COVID-19 pandemic.1 Racial disparities are also extreme: Black women in the U.S. are nearly three times more likely to die from pregnancy-related complications than white women are. But maternal deaths and complications may be an indicator of the nation’s wider failures with respect to women’s health and health care. Compared to women in other high-income countries, American women have long had worse access to the health care they need. While the U.S. spends more on health care than other countries do, surveys regularly find that Americans avoid seeking care because of costs at the highest rates, even as the U.S. continues to lead in the prevalence of chronic disease.2 At the same time, limited access to primary care and inadequate coordination of health services are likely factors in the nation’s poor performance when it comes to the prevention, diagnosis, and management of diseases.3 In this brief, we compare selected measures of health care access and outcomes for women in high-income countries. We drew upon data from four sources: the Commonwealth Fund’s 2023 International Health Policy Survey of Australia, Canada, France, Germany, the Netherlands, New Zealand, Switzerland, the United Kingdom, and the United States, which allowed us to analyze responses by race and ethnicity;4 the Centers for Disease Control and Prevention National Vital Statistics System; the Organisation for Economic Co-operation and Development (OECD); and the Institute for Health Metrics and Evaluation Global Burden of Disease. The latter two data sets permitted us to show results on selected measures for five additional countries — Chile, Japan, Korea, Norway, and Sweden. (See “How We Conducted This Survey” for more details.)
Topic:
Women, Public Health, Healthcare System, and Life Expectancy
Political Geography:
United Kingdom, Canada, France, Germany, Australia, and United States of America

8. Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System

Author:
David Blumenthal, Evan D. Gumas, Arnav Shah, Munira Z. Gunja, and Reginald D. Williams II
Publication Date:
09-2024
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
Goal: Compare health system performance in 10 countries, including the United States, to glean insights for U.S. improvement. Methods: Analysis of 70 health system performance measures in five areas: access to care, care process, administrative efficiency, equity, and health outcomes. Key Findings: The top three countries are Australia, the Netherlands, and the United Kingdom, although differences in overall performance between most countries are relatively small. The only clear outlier is the U.S., where health system performance is dramatically lower. Conclusion: The U.S. continues to be in a class by itself in the underperformance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.
Topic:
Development, Public Health, Efficiency, and Healthcare System
Political Geography:
North America and United States of America

9. Boosting Childhood Vaccination Rates Post-Pandemic: Lessons from Five Countries

Author:
Irene Papanicolas, Robert A. Berenson, and Laura Skopec
Publication Date:
10-2024
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
Issue: Childhood vaccination rates fell worldwide during the COVID-19 pandemic. However, reductions in childhood vaccination were not universal, which may be related to differences in vaccine eligibility, vaccine hesitancy, and vaccine administration programs across countries. Goals: Explore how childhood vaccination rates changed during the COVID-19 pandemic in five high-income countries with varying approaches to vaccine policy. Methods: Surveys of in-country experts and analysis of secondary data sources in Australia, Germany, Singapore, the United Kingdom, and the United States. Key Findings and Conclusion: While vaccination rates fell worldwide during the COVID-19 pandemic, the high-income countries in our study maintained high childhood vaccination rates for polio and measles-mumps-rubella (MMR) near or above the herd immunity threshold (80% for polio and 95% for measles). Australia and Singapore, which have the strictest vaccine requirements, boasted the highest polio vaccination rates in both 2018 and 2021. No countries require the human papillomavirus (HPV) vaccination nationwide, but Australia, Singapore, and the U.K. have school-based HPV vaccination programs and high vaccination rates. Strong vaccine requirements, combined with school-based immunization or catch-up programs, may help boost childhood vaccination rates where they lagged during the pandemic.
Topic:
Children, Vaccine, COVID-19, and Healthcare System
Political Geography:
United Kingdom, Germany, Australia, Singapore, and United States of America

10. Finger on the Pulse: The State of Primary Care in the U.S. and Nine Other Countries

Author:
Evan D. Gumas, Corinne Lewis, Celli Horstman, and Munira Z. Gunja
Publication Date:
03-2024
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
For many people, primary care is their first point of contact with the health system, and decades of evidence shows it is critical for population health, health equity, and the overall efficiency of health care systems.1 Primary care is also uniquely positioned to screen for social needs and provide integrated behavioral health services.2 Ensuring people have access to high-quality, comprehensive primary care is vital to good health outcomes and positive experiences with the health system at large. Despite the importance of primary care, health systems around the world are facing challenges at the patient and provider level. Many countries struggle to ensure access to care, or first contact; continuity of care; comprehensiveness of care; and coordination of care. These four core components of high-quality primary care are essential to better overall health outcomes.3 Factors like workforce shortages, physician burnout, and dwindling access for patients, driven in part by underinvestment and growing administrative burdens, pose significant barriers to care.4 To better understand how patient care can be improved in a changing primary care landscape, this brief compares the state of primary care in the United States with nine other high-income nations. It updates an earlier Commonwealth Fund study comparing primary care performance in the U.S. with nine peer countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, and the United Kingdom. Our data come from the Commonwealth Fund’s 2022 International Health Policy Survey of Primary Care Physicians and the 2023 International Health Policy Survey of adults age 18 and older. The 2022 and 2023 surveys asked different questions of the participating physicians and responding adults, so this edition includes new measures on access to telehealth, preparedness to treat behavioral health conditions, and care coordination. For more details on our methods, see “How We Conducted This Study.”
Topic:
Equity, Primary Care, and Healthcare System
Political Geography:
United Kingdom, Canada, France, Germany, Australia, Switzerland, North America, Sweden, Netherlands, New Zealand, and United States of America