Patient Mobility, Health Care Quality, Welfare And Regulation
What is governmental effectiveness on the regional level? How can the study of regional effectiveness help us understand the performance of the political, social and economic systems of the state as a whole? These questions are very important from both the theoretical and applied perspectives, and the Russian Federation, with its huge and diverse territory, provides extremely rich material to answer them. Serious institutional reforms in the public sector have been implemented in recent years, and the results vary substantially from one region to another. So, in Russia, we can study how general attempts to make government more effective - guided by federal policies - produce particular regional effects, and, conversely, how regions implement federal policy differently. Both views tell us something important about overall governmental quality.
Governmental effectiveness, though in a broad sense one of the oldest issues in political science and philosophy, is currently enjoying a renaissance. The quantity of recent publications and even a special academic structure - The Quality of Government Institute in Sweden – illustrate the current interest. However, researching governmental effectiveness poses serious difficulties, on both the conceptual and instrumental levels. Despite (perhaps even because of) the variety of available theoretical frameworks, the essential core notions of governmental effectiveness and good governance remain murky. Furthermore, scholars disagree about what effectiveness and efficiency mean in a general sense. These issues obviously make it difficult to construct adequate measurement instruments.
The paper seeks to achieve three goals: 1) to review existing approaches and highlight their weak points; 2) to propose a theoretical framework for analyzing governmental effectiveness using appropriate estimation tools; and 3) to present empirical results based on data on public health care from Russia’s regions. Three patterns that ought to correlate - regional efficiency, how reform has been implemented and public opinion – are, instead, inconsistent with each other. Russia’s health-care sector today faces considerable problems with basic, systemic effectiveness.
The article distinguishes the reasons for insufficient development of competition in the sphere of medicine; identifies the major types of such competition, and emphasizes that it can increase the quality of medical support for consumers.
This paper justifies unequal health care quality in a model with two regions and patients differentiated by location and quality perception. There are two efficient regimes of health care quality provision. In the presence of high travel and quality provision costs, qualities should be equal. Reducing these costs results in unequal distribution of quality in effective solution. High health care inequality under a centralised solution is better for the majority of the population as well as for both regions, if the costs are sufficiently low. Market equilibrium implements an efficient solution only when there are high travel and quality provision costs.
Smoking is a problem, bringing signifi cant social and economic costs to Russiansociety. However, ratifi cation of the World health organization Framework conventionon tobacco control makes it possible to improve Russian legislation accordingto the international standards. So, I describe some measures that should be taken bythe Russian authorities in the nearest future, and I examine their effi ciency. By studyingthe international evidence I analyze the impact of the smoke-free areas, advertisementand sponsorship bans, tax increases, etc. on the prevalence of smoking, cigaretteconsumption and some other indicators. I also investigate the obstacles confrontingthe Russian authorities when they introduce new policy measures and the public attitudetowards these measures. I conclude that there is a number of easy-to-implementanti-smoking activities that need no fi nancial resources but only a political will.
One of the most important indicators of company's success is the increase of its value. The article investigates traditional methods of company's value assessment and the evidence that the application of these methods is incorrect in the new stage of economy. So it is necessary to create a new method of valuation based on the new main sources of company's success that is its intellectual capital.