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51. 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

52. 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

53. 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

54. 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

55. The Pillars of Governance. A Macro-Quantitative Analysis of Governance Performance

Author:
Gregor Walter-Drop, John Wiesel, and Melissa Lee
Publication Date:
05-2016
Content Type:
Working Paper
Institution:
Collaborative Research Center (SFB) 700
Abstract:
State building is seen as the central tenet of many present-day development efforts. This rests on a global normative script that emphasizes the modern state’s role in providing governance services from security to education to health. However, the relationship between statehood and governance outcomes is not well understood. We use a macro-quantitative approach to analyze state performance in various governance dimensions including security, health, education, economic subsistence, infrastructure, and the environment. We test for the power of statehood in explaining the variation in governance outcomes while controlling for various other factors prominent in the respective debates in political science, economics, and development studies. The analysis yields three interesting results. First, statehood does not have a consistent significant relationship with governance outcomes. It matters more for some outcomes than for others. Second, we find that statehood sometimes performs better at predicting subjective (survey-based) evaluations than at predicting objective measures of governance outcomes (which confirms the ubiquity of the normative script). Finally, we find that the degree of domestic female empowerment performs consistently strong at explaining the variation in governance outcomes. This result is consistent with the policy community’s emphasis on women’s roles in development.
Topic:
Security, Education, Health, Infrastructure, Governance, and State Building
Political Geography:
Global Focus

56. Disability Rights in Global Perspective

Author:
Karen Nakamura
Publication Date:
04-2016
Content Type:
Video
Institution:
Clarke Forum for Contemporary Issues
Abstract:
Grassroots disability movements such as mad pride and crip pride have pushed themselves to the forefront of conversations across the world about diversity and inclusion, but there has also been considerable setbacks in recent years. Karen Nakamura discusses disability rights social movements and how they have fundamentally changed the social contract and fabric in various countries.
Topic:
Health, Human Rights, Social Movement, Health Care Policy, Social Justice, Disability, and Mental Health
Political Geography:
Japan, Asia, North America, Global Focus, and United States of America

57. Advancing Drug Policy Reform: a new approach to decriminalization

Author:
Global Commission On Drug Policy
Publication Date:
07-2016
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
Building on current partial decriminalization models that have helped to achieve more effective drug policies and positive outcomes, with a greater emphasis on justice, dignity and human rights, this report advocates ending all penalties – both civil and criminal – on people who use drugs. Detailing the destructive and harmful consequences of punitive drug policies and the need to reconsider them, the report calls for the implementation of alternatives to punishment for all low-level, non-violent actors in the drug trade, and to consider market regulation as the next logical step.
Topic:
Health, War on Drugs, Drugs, Public Health, and Criminology
Political Geography:
Global Focus

58. 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

59. The Negative Impact of Drug Control on Public Health: the global crisis of avoidable pain

Author:
Global Commission On Drug Policy
Publication Date:
10-2015
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
Ninety-two percent of the world’s supply of morphine is consumed by just 17 percent of the global population, with consumption primarily concentrated in the global north and 75 percent of the world’s population does not have access to any pain relieving drugs. The reasons for this have little to do with issues of cost or scarcity of supplies- and everything to do with with the prohibition and repressive stand the world has taken on drugs. This Global Commission report explores the current crisis related to the lack of access to controlled medicines and makes concrete policy recommendations to Member States and UN agencies on ways to improve these conditions. This report is available in English, Spanish, Russian, French and Arabic.
Topic:
Health, War on Drugs, Drugs, Public Health, and Medicine
Political Geography:
Global Focus

60. Alternatives to High-Risk Radiological Sources

Author:
Miles A. Pomper, Egle Murauskaite, and Tom Coppen
Publication Date:
03-2014
Content Type:
Working Paper
Institution:
James Martin Center for Nonproliferation Studies
Abstract:
There is growing global awareness of the need to secure radiological sources in order to prevent terrorists from using such materials in a radiological weapon, such as a “dirty bomb.” A new CNS report calls for a move towards permanently reducing this threat by substituting non-isotopic alternatives for these sources in civil uses. As an initial step, the authors propose a move towards gradual phase-out of cesium chloride use in pre-transfusion blood irradiation on a global scale – a domain where non-isotopic alternatives are considered to be the most viable in the short-term. They urge United States to launch an international initiative involving the phase out of cesium-chloride and other high-risk radiological sources as a “gift basket” for the upcoming 2014 Nuclear Security Summit. Cesium chloride is one of the most commonly used radiological materials, despite being an IAEA Category 1 “extremely dangerous” source. Because cesium chloride is easily dispersible, water soluble, and relatively easy to handle, it is particularly suitable for terrorist purposes. The blood irradiators that use it as a source are located in many large hospitals and blood banks (inherently publicly accessible spaces), and the source is usually transported through regular civilian infrastructure at the beginning and the end of its lifecycle, giving more cause for concern. Cesium chloride based irradiators are used to treat blood and blood products prior to transfusion in order to prevent a rare but fatal Graft Versus Host Disease (GVHD). A growing number of non-isotopic alternatives are becoming available for that purpose, but there is a serious lack of awareness about the range of options and how they compare to current practices, both among the medical professionals and national regulators.
Topic:
Health, Biological Weapons, Radiological Weapons, and Medicine
Political Geography:
Global Focus