Enter the Supermarket: Entrepreneurial Medical Practice in New Zealand

1992 ◽  
Vol 10 (3) ◽  
pp. 267-281 ◽  
Author(s):  
R A Kearns ◽  
J R Barnett

New Zealand, like many other capitalist countries, has recently witnessed an increased corporate involvement in medicine. One manifestation of this change has been the entry of medical ‘supermarkets’—multipurpose clinics which juxtapose general practitioners (GPs) and specialists, are company owned, and employ advertising. The authors document the development and implications of these clinics which, although small in number, have induced change in the behaviour of the GP community at large. They conclude that recent developments involve a ‘coming out of the closet’ of a fundamental contradiction in the way general practice is conducted in New Zealand. This is between the role of the caring providers founded on the Hippocratic oath, and that of income-generating business people within an increasingly market-driven society. This contradiction leads to speculation on a broader question: The degree to which competition among primary care provides is possible within fee-for-service and other types of health-care systems.

Author(s):  
Pierre Pestieau ◽  
Mathieu Lefebvre

This chapter reviews the public health care systems as well as their challenges. It first shows how expenditure on health care has evolved in previous decades and deals with the reasons for the growth observed in almost every European country. It emphasizes the role of technological progress as a main explanatory factor of the increase in medical expenditure but also points to the challenges facing cost-containment policies. Especially, the main common features of health care systems in Europe, such as third-party payment, single provider approach and cost-based reimbursement are discussed. Finally the chapter shows that although inequalities in health exist in the population, health care systems are redistributive. Reforms are thus needed but the trade-off between budgetary efficiency and equity is difficult.


2013 ◽  
Vol 54 (1) ◽  
pp. 33-63 ◽  
Author(s):  
Sara Rzayeva

AbstractHealth care systems reflect historical relationships between states and citizens, as well as predominant values and institutions marking a particular social milieu. Theories that place national health care in historical social context tend to exaggerate the forces of globalization and to underestimate the role of local specificities. A health care system and its social context, however, are shaped at the intersection of global, regional, and local factors, rather than by globalization alone. In this article I demonstrate this combined influence by tracking the transition in Soviet to post-Soviet health care Azerbaijan. I show that the dissolution of Azerbaijan’s socialized health care was due not to neoliberal globalization, but rather to the historical constellation of global, regional, and national processes, including the political choice of a petroleum-based development strategy.


1999 ◽  
Vol 3 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Chantal M. Cara,

The caring role of nurses is not impervious to obstacles that might be present in today’s health care systems. Such obstacles might occur when nurses do not feel cared for by their nurse managers. Through the “Relational Caring Inquiry”, 16 staff nurses were asked to answer two questions pertaining to their personal experiences with a nurse manager and how these experiences influenced their caring practice. Concerning managerial practices, the staff nurses’ stories revealed the presence of a “Dialectic of Power”, involving two contradictory forces: subjugation and empowerment. These findings can assist managers to better create a caring environment within the institution and help sensitize nurses to patients’ suffering.


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