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In the western world, the characteristic age of the patient population who require the most medical support for longer durations is increasing. The current model for supporting health care is not sustainable for this greater need. Given... more
In the western world, the characteristic age of the patient population who require the most medical support for longer durations is increasing. The current model for supporting health care is not sustainable for this greater need. Given that the web has emerged as a daily part of life for much of the western world, it may be one route to
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... 17 Table 4: State Commitments on Procurement Provisions in US FTAs 20 Table 5: Openness to Trade: How the US Fares Today under the GATS 24 Table 6: Features of Selected Congressional Health Plans 27 Table 7: Health and Social Service... more
... 17 Table 4: State Commitments on Procurement Provisions in US FTAs 20 Table 5: Openness to Trade: How the US Fares Today under the GATS 24 Table 6: Features of Selected Congressional Health Plans 27 Table 7: Health and Social Service Providers by State 34 ...
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This paper evaluates the domestic and international legal challenges against the Australian government's plain packaging legislation initiated by the tobacco industry.
ABSTRACT The European Union’s new architecture of fiscal and economic governance can be difficult to understand. How do two legislative packages, a treaty, a strategy and a “European Semester” interact to shape member state policies? This... more
ABSTRACT The European Union’s new architecture of fiscal and economic governance can be difficult to understand. How do two legislative packages, a treaty, a strategy and a “European Semester” interact to shape member state policies? This paper argues, on the basis of a review and presentation of the new fiscal governance architecture, that what we see is a hardening of European soft law. The new European Union fiscal governance involves both tougher and more automatic sanctions for states that violate the Stability and Growth Pact, and an expansion of mechanisms of surveillance and Commission involvement in member state economic and fiscal planning. The result is planned to combine the information and constant surveillance of soft law with the judicial enforceability and tough sanctions of hard law.
ABSTRACT Since devolution, the United Kingdom has evolved not only in terms of political representation but also in terms of the relationships between civil servants in each of its regions. In this paper, we present an analysis of the... more
ABSTRACT Since devolution, the United Kingdom has evolved not only in terms of political representation but also in terms of the relationships between civil servants in each of its regions. In this paper, we present an analysis of the distinct professional and educational backgrounds of elite civil servants in Scotland, Wales, and Northern Ireland. Using a new database of professional biographies of top officials across all four jurisdictions, we assess the extent to which civil servants in these UK regions are organizationally and professionally distinct from one another and from those in the UK-wide departments. We conclude that despite organizational change, the recruitment, demographics, and career structures of top officials in the four jurisdictions are actually quite similar. Comparing our findings to earlier studies by others, it seems that this is because the Cameron governments appear to have overseen a resurgence of traditional civil servants.
ABSTRACT Governments at the Federal and State levels in the United States are investing significant funding to support the exchange of health information among organizations in the health system, in what is essentially a large scale... more
ABSTRACT Governments at the Federal and State levels in the United States are investing significant funding to support the exchange of health information among organizations in the health system, in what is essentially a large scale experiment involving collaborative governance and big data. Using qualitative data derived from multiple primary and secondary sources and interviews, this paper reports on a project examining Health Information Exchange (HIE) implementation at the Federal level and in the state of Michigan. Lessons are drawn from this case that can inform HIE implementation, and Health IT adoption more broadly, in other states and at the Federal level.
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ABSTRACT Information asymmetry between consumers and supply chain actors represents a major barrier to the expansion of sustainable consumption. Developing an interoperable data architecture that enables the integration of data regarding... more
ABSTRACT Information asymmetry between consumers and supply chain actors represents a major barrier to the expansion of sustainable consumption. Developing an interoperable data architecture that enables the integration of data regarding sustainability practices from disparate sources in sustainable supply chains is important for improving market transparency. This paper identifies main issues and requirements as perceived by the key stakeholders in the coffee supply chain for such development. The analysis reveals that building an interoperable data architecture necessitates awareness of several major challenges, including the difficulties of collecting accurate and creditable data, limited technological capabilities, complex data ownership and disclosure policy, issues of confidentiality, privacy and economic value of information, and cost of disclosing information. To deal with these challenges, we recommend that the development need to ensure data quality, integrity and security, design information policy balancing commercial interests and openness, and design appropriate governance mechanism to complement the technological design in order to ensure the fair and proper use of the system.
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ABSTRACT Consumers demand information about product sustainability, pushing for government actions and private regulations. Both approaches can benefit from applying information technologies, but sharing information may also prompt... more
ABSTRACT Consumers demand information about product sustainability, pushing for government actions and private regulations. Both approaches can benefit from applying information technologies, but sharing information may also prompt conflicts of interest among stakeholders. We propose using convention theory and case studies to analyze potential conflicts and possible ways to overcome them.
ABSTRACT Participants in this panel will explore opportunities, barriers and value creation involved in public-private partnerships to better inform consumers in their decision making processes and to promote a more sustainable system.
In the past decade, the EU has experimented with various types of consultation mechanisms intended to address perceived deficits in policy knowledge and decision-making legitimacy within the European system. I examine attempts by the... more
In the past decade, the EU has experimented with various types of consultation mechanisms intended to address perceived deficits in policy knowledge and decision-making legitimacy within the European system. I examine attempts by the European Commission to build up its decision-making legitimacy and inform policy via various formal mechanisms, focusing on the extent to which the relationship between the Commission
ABSTRACT International medical travel, or medical tourism, is receiving attention globally. Most discussions focus on the potential savings from outsourcing medical care. This article adopts a comparative approach, identifying lessons... more
ABSTRACT International medical travel, or medical tourism, is receiving attention globally. Most discussions focus on the potential savings from outsourcing medical care. This article adopts a comparative approach, identifying lessons from European Union discussions that illuminate areas left obscure in the broader international debate. First, it points out that the highly visible US debate, focused on cost, is ignoring two other crucial components of health care policy: access and quality. Second, it examines debates about medical travel in the European Union in order to understand the kinds of issues that arise when considering access and quality in medical travel, the political discussions that emerge, and the solutions that the EU has been able to adopt. The conclusion identifies issues that the EU has faced and that will arise as debates about international medical travel start to incorporate access and quality.
... 17 Table 4: State Commitments on Procurement Provisions in US FTAs 20 Table 5: Openness to Trade: How the US Fares Today under the GATS 24 Table 6: Features of Selected Congressional Health Plans 27 Table 7: Health and Social Service... more
... 17 Table 4: State Commitments on Procurement Provisions in US FTAs 20 Table 5: Openness to Trade: How the US Fares Today under the GATS 24 Table 6: Features of Selected Congressional Health Plans 27 Table 7: Health and Social Service Providers by State 34 ...
... lead researchers. Scott Greer, from University College London and the University of Michigan, takes as his broad themes the way the department fulfils its core functions, and the backgrounds of its senior leadership. His starting ...
Abstract Current trends in making supply chains more transparent and bringing information usually not available to the consumer and other players into the market are changing the ways in which consumers make decisions about the goods and... more
Abstract Current trends in making supply chains more transparent and bringing information usually not available to the consumer and other players into the market are changing the ways in which consumers make decisions about the goods and services they buy. One ...
European countries are opening, some as quickly as the brashest American states, but with far more testing, attention to health care capacity and data than the United States. For their citizens, that means it might go better for them than... more
European countries are opening, some as quickly as the brashest American states, but with far more testing, attention to health care capacity and data than the United States. For their citizens, that means it might go better for them than for Americans.
Tobacco industry denormalization is a key strategy for tobacco control that has been formalized in the WHO Framework Convention on Tobacco Control. International trade and investment laws are a potential threat to tobacco industry... more
Tobacco industry denormalization is a key strategy for tobacco control that has been formalized in the WHO Framework Convention on Tobacco Control. International trade and investment laws are a potential threat to tobacco industry denormalization because they do not automatically incorporate denormalization and, in theory, treat tobacco firms like other commercial interests. Countries that seek to defend tobacco control policies against international trade and investment challenges need to have good governance in two senses: good governance as understood by tribunals and good‐enough governance to manage the processes and requirements that enable policies to survive international challenges.
All forms of Brexit are bad for health, but some are worse than others. This paper builds on our 2017 analysis using the WHO health system building blocks framework to assess the likely effects of Brexit on the National Health Service... more
All forms of Brexit are bad for health, but some are worse than others. This paper builds on our 2017 analysis using the WHO health system building blocks framework to assess the likely effects of Brexit on the National Health Service (NHS) in the UK. We consider four possible scenarios as follows: a No-Deal Brexit under which the UK leaves the EU on March 29, 2019, without any formal agreement on the terms of withdrawal; a Withdrawal Agreement, as negotiated between the UK and EU and awaiting (possible) formal agreement, which provides a transition period until the end of December, 2020; the Northern Ireland Protocol's backstop coming into effect after the end of that period; or the Political Declaration on the Future Relationship between the UK and EU. Our analysis shows that a No-Deal Brexit is substantially worse for the NHS than a future involving the Withdrawal Agreement, which provides certainty and continuity in legal relations while the Political Declaration on the Future Relationship is negotiated and put into legal form. The Northern Ireland backstop has varying effects, with continuity in some areas, such as health products, but no continuity in others. The Political Declaration on the Future Relationship envisages a relationship that is centred around a free-trade agreement, in which wider health-related issues are largely absent. All forms of Brexit, however, involve negative consequences for the UK's leadership and governance of health, in both Europe and globally, with questions about the ability of parliament and other stakeholders to scrutinise and oversee government actions.
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A recent trade dispute between the USA and Indonesia, overseen by the World Trade Organization, challenges piecemeal approaches to tobacco regulation.
European Union (EU) healthcare services policy has been largely driven by the European Court of Justice (ECJ) applying the law of the internal market to the previously separate area of healthcare systems. We argue that it opened up two... more
European Union (EU) healthcare services policy has been largely driven by the European Court of Justice (ECJ) applying the law of the internal market to the previously separate area of healthcare systems. We argue that it opened up two major risks: that health service planning would be disrupted by cross-border flows of patients and professionals, including ostensibly interchangeable professionals or
This paper presents the challenges associated with developing a data architecture supporting information interoperability in the supply-chain for sustainable food products. We analyze information elicited from experts in the supply-chain... more
This paper presents the challenges associated with developing a data architecture supporting information interoperability in the supply-chain for sustainable food products. We analyze information elicited from experts in the supply-chain for organic and fair trade coffee to identify relevant stakeholders and the issues and challenges connected with developing an interoperable data architecture. This study assesses the salience of individual stakeholder
Abstract will be provided by author.
In the wake of the 2008 financial crisis, the UK government faces some tough choices over public expenditure, and these choices will have important implications for both the future of health policy and the way in which health services are... more
In the wake of the 2008 financial crisis, the UK government faces some tough choices over public expenditure, and these choices will have important implications for both the future of health policy and the way in which health services are managed. In this article, we examine the organization and leadership of the UK Department of Health and weigh its suitability to meet such challenges. We find an organization that is culturally split between public servants and managers, highly reliant on the ability of its key personnel to bridge these divides, and extremely responsive to the political goals of government ministers. We explore the modern DH using three types of evidence. First, the history of the department shows clear political efforts to reduce civil service discretion and focus the DH on the management of the English NHS. Second, the recent organizational structures of the DH show a bifurcation between policy direction and NHS management tasks. Third, an analysis of the top ranks of the department since 2005 shows the implementation of political preferences that are consistent with managerialism but inconsistent with the perceived characteristics of traditional civil servants. The result is a department which has changed just as frequently as the health service it oversees – a department which has been moulded by successive ministers into one for the management of the NHS. Our findings raise important questions about the value and purpose of long-term organizational knowledge in policy formulation.
ABSTRACT This article asks who works in Whitehall today. We argue that there are points of consensus about the nature of ‘Whitehall’, including generalism, internal labour markets, Oxbridge education, and lifetime careers. An analysis of... more
ABSTRACT This article asks who works in Whitehall today. We argue that there are points of consensus about the nature of ‘Whitehall’, including generalism, internal labour markets, Oxbridge education, and lifetime careers. An analysis of 306 biographies of the top team of the UK civil service, which goes beyond existing published use of biographical data on the topic, allows us to compare the civil service with this model. We find that in every respect the descriptive usefulness of a Whitehall model is weak. Whitehall is no longer marked by internal labour markets, Oxbridge dominance, or lifetime careers, and there are signs of reduced generalism. Furthermore, many of the most politically salient departments appear to be leading the way towards a different public sector model premised on managerial, policy expertise rather than civil service generalism and loyalty.
Abstract will be provided by author.

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This book investigates the ways in which these systems can promote public value by encouraging the disclosure and reuse of privately-held data in ways that support collective values such as environmental sustainability. Supported by... more
This book investigates the ways in which these systems can promote public value by encouraging the disclosure and reuse of privately-held data in ways that support collective values such as environmental sustainability. Supported by funding from the National Science Foundation, the authors' research team has been working on one such system, designed to enhance consumers ability to access information about the sustainability of the products that they buy and the supply chains that produce them. Pulled by rapidly developing technology and pushed by budget cuts, politicians and public managers are attempting to find ways to increase the public value of their actions. Policymakers are increasingly acknowledging the potential that lies in publicly disclosing more of the data that they hold, as well as incentivizing individuals and organizations to access, use, and combine it in new ways.  Due to technological advances which include smarter phones, better ways to track objects and people as they travel, and more efficient data processing, it is now possible to build systems which use shared, transparent data in creative ways. The book adds to the current conversation among academics and practitioners about how to promote public value through data disclosure, focusing particularly on the roles that governments, businesses and non-profit actors can play in this process, making it of interest to both scholars and policy-makers.
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Public health policies are increasingly the subject of global trade and investment disputes. What are the consequences of this trend for existing and future policies designed to protect the public interest? This book uses the concept of... more
Public health policies are increasingly the subject of global trade and investment disputes. What are the consequences of this trend for existing and future policies designed to protect the public interest? This book uses the concept of political conflict to examine the effects of globalization on tobacco control policies. Arguing that the scope of a political conflict – which voices can be heard in a particular debate, and which individuals or groups are excluded - has a significant effect on support for public health policies, the book examines how the global trading system has narrowed the scope of conflicts over tobacco control. Analyzing challenges to policies enacted by Australia, Canada, the United States, the European Union and Uruguay, this book offers a critical look at the exclusionary global trading system and outlines what can be done to fix it.
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by Scott L. Greer, Nick Fahy, Heather A. Elliott, Matthias Wismar, Holly Jarman, Willy Palm What does the European Union mean for health and health systems? More than one would think. The EU’s health mandate allows for a comprehensive... more
by Scott L. Greer, Nick Fahy, Heather A. Elliott, Matthias Wismar, Holly Jarman, Willy Palm

What does the European Union mean for health and health systems? More than one would think. The EU’s health mandate allows for a comprehensive set of public health actions. And there are other EU policies, though not health related, which have important consequences for governing, financing, staffing and delivering health services.  In other words: EU actions affect the health of Europe’s population and the performance of health systems.

Given how important health systems are, we need an informed debate on the role of the EU and its contribution. But this is not easy because EU health policy is difficult to comprehend. There is no single strategy with a neat body of legislation implementing it; rather, there are many different objectives and instruments, some of which appear in unlikely places.

Understanding the EU role in health is especially important now, when health systems have to deal with a plethora of challenges, the European social model is confronted by the threat posed by the financial crisis, and the EU is facing increasing euro-scepticism in politics.

This short book makes EU health policy in its entirety (and complexity) accessible to political and technical debate. To this end the volume focuses on four aspects of EU health policy:

the EU institutions, processes and powers related to health;
the EU action taken on the basis of this health mandate;
the non-health action affecting health and health systems;
and, because of its growing importance, financial governance and what it means for European health systems.
This book is aimed at policymakers and students of public health and health systems in the EU who want to understand how the EU can add value in their quest improving population health and the performance of health systems in Member States.
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By J. S. Luciano, G. P Cumming, E. Kahana, M. D. Wilkinson, E. H. Brooks, H. Jarman, D. L. McGuinness and M. S. Levine The transformative power of the Internet on all aspects of daily life, including health care, has been widely... more
By J. S. Luciano, G. P Cumming, E. Kahana, M. D. Wilkinson, E. H. Brooks, H. Jarman, D. L. McGuinness and M. S. Levine

The transformative power of the Internet on all aspects of daily life, including health care, has been widely recognized. These transformations reveal opportunities realized, the promise of future advances, and the problems created by the penetration of the World Wide Web for both individuals and for society at large. Health Web Science explores the role of the Web as it drives discussions, technologies, policies, and solutions related to health. We also examine the impact of the Web's health-related uses on the design, structure and evolution of the Web itself. The orientation of Health Web Science, compared to related research domains, motivates innovation in Web technology and better utilization of the Web for communication, collaboration, information access and sharing, remote sensing, and even remote treatment.
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