The human right to health: exploring disability,migration and health

Across the globe, an estimated one billion people are on the move today, of whom 244 million are international migrants. Not only have global horizons expanded in the realm of work and study; global conflict and exploitation have resulted in forced migration. Migration is a political issue, which raises questions of identity, citizenship, diversity and integration and is utilised to play upon the fear of the stranger, the ‘Other’ and difference in contemporary society. Disabled migrants are a hidden population whose experiences are often overlooked or subsumed within wider debates around disability and ethnicity. This article considers the intersection of disability and migration in contemporary society through the lens of healthcare access. Reflecting on the impact of citizenship rights on the realisation of human rights in the context of contemporary migration, using health as an example, the article considers the implications for disabled migrants, focusing primarily on the European Union.     

Critical analysis of contractual regulation mechanisms: An organizational approach

Starting from the contract as a coordination mechanism, this article questions the effectiveness of contractual regulatory mechanisms, i.e. the ability of regulation to attain its goal, not only in efficiency terms through the analysis of the production function, but also in organizational terms. Theories of agency and transaction costs are well-suited to investigation of coordination problems in regulation. The relationship between the regulator and the regulated firm has to be regarded as a principal-agent relationship included in a more general framework taking into consideration the differentiated effects of internal incentives schemes and of the labor, goods and capital markets as additional external incentive mechanisms to correct the behaviour of the regulated firm. Improvement of regulation rests on the regulated firm's capacity to minimize transaction costs associated with the whole coordination problem. The distinction between regulated private enterprise and public enterprise allows one to identify the property rights costs.     

A value‐driven approach to health care

Redefining Healthcare: Creating Value‐Based Competition on Results, by Michael E. Porter and Elizabeth O. Teisberg. Boston: Harvard Business School Press, 2006. 506 pp., $35.00 cloth.     

The savings approach to financing long-term care in Singapore

Singapore is grappling with provision of services for the current generation of older people at the same time as building the foundation for the coming generations of elderly. In this article, I analyze four sets of factors that are shaping long-term care policy and financing in ways that are almost unique to Singapore. First, current developments can only be understood in the context of the Central Provident Fund (CPF) that was established by the Government of Singapore in the 1950s to ensure that the working population saved for retirement; the Medisave and related schemes for financing health care were subsequently developed alongside the CPF. Most recently, the existing funding arrangements have been extended to some long-term care services, and options for further extensions are under consideration. Second, the government's philosophy of maintaining the primacy of family support for the elderly has been expressed through a number of initiatives that provide financial and other incentives to families, combined with an emphasis on community care. The third factor is the relationship between government and the voluntary welfare organizations that are the major providers of institutional and community services. Finally, a series of government-sponsored reviews and advisory councils have provided for widespread consultation on policy options. These developments are directed to achieving a multi-pillar approach in which intergenerational transfers through taxation will be limited, and the role of individual savings and insurance will be increased.     

Child care improvement on a shoestring: evaluating a low-cost approach to improving the availability of quality child care

The Philadelphia Early Childhood Collaborative (the Collaborative) was designed to improve the quality of child care by increasing coordination among organizations that locally deliver professional resources to child care providers. The evaluation examined the implementation of the Collaborative, utilization of its services, and the impact of service use on child care quality. Child care providers reported gains in their professional knowledge and behavior from using Collaborative resources and rated the resources highly. No long-term effects on provider behavior, knowledge, or attitudes were observed. Although the original organizations were able to function collaboratively and Collaborative services were widely used, more intensive interventions may be required to change the availability of quality child care.     

The impact of AIDS on foster care: a family-centered approach to services in the United States

This article highlights current changes in our understanding of HIV infection in children; examines two central concepts--family-centered care and prevention--for the development of child welfare services; and explores certain implications for foster care for HIV-infected children while reviewing the training needed by foster care personnel and foster parents if they are to provide competent services.     

Psychiatric triage: a cost-effective approach to quality management in mental health.

As seen from this trial program, psychiatric triage in the ED is potentially a very effective tool for improving the quality of mental health patient care. For a minimal investment in personnel, there is a potential for a major improvement in patient care, patient record documentation, interdepartmental relations, and financial reimbursement to the institution.