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Health Policy Developments Issue 3: Focus on Accountability, (De)Centralization, Information Technologiesogies

Busse R, Schlette S
Gütersloh: Bertelsmann Foundation Publishers


The third issue of “Health Policy Developments” pays special attention to five concurrent health policy topics, all of them high on health policy agendas in a variety of developed countries:

– Accountability and participation
– Coordination of care
– Public health and prevention
– Centralization versus decentralization
– Technical innovations and bioethics

Two of these topics, accountability and prevention, are of particular interest to the Bertelsmann Stiftung.
As an independent yet not neutral player in the German health care system, the Foundation examines health care services and health policy reform from the specific, usually underrepresented viewpoint of the insured themselves. Much lip service has been paid to the importance of the informed patient, the patient as the focus of attention, and the patient’s responsibility to participate in the maintenance of good health and in the treatment process. In practice, however, little has changed. Many stakeholders—insurers, physicians, politicians, and the health care industry—- claim to know what is best for the patients or so-called health care consumers.
Behind these claims often lurk profit interests, professional self-esteem, or—a variation of profit interests—the politician’s pursuit of re-election. While this is not the place to challenge the legitimacy of business or power interests, recent experience has indeed shown just how important patient views are to policymakers. In fact, politicians are increasingly sensitive and attentive to their voters’ concerns about health care.

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