Shutdown hits health services, but Obamacare steams on

Shutdown hits health services, but Obamacare steams on.

The future of Obamacare.

n engl j med 367;23 nejm.org december 6, 2012 2165 it passed Congress without a sin­ gle Republican vote, and the GOP subsequently mounted legal and legislative challenges to Obama­ care, vowing to repeal and re­ place it. The Supreme Court decision in June 2012 upholding the ACA’s constitutionality dealt a serious blow to the law’s opponents. Now, in the aftermath of the 2012 elections, with P...

Policy Capacity for Health Reform: Necessary but Insufficient; Comment on “Health Reform Requires Policy Capacity”

Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acut...

Economic downturn hits ORs, but few layoffs of periop staff.

Decentralisation – A Portmanteau Concept That Promises Much but Fails to Deliver?; Comment on “Decentralisation of Health Services in Fiji: A Decision Space Analysis”

Decentralisation has been described as an empty concept that lacks clarity. Yet there is an enduring interest in the process of decentralisation within health systems and public services more generally. Many claims about the benefits of decentralisation are not supported by evidence. It may be useful as an organising framework for analysis of health systems but in this context it lacks conceptu...