James J. Murphy, Ariel Dinar, Richard E. Howitt, Erin Mastrangelo, Stephen J. Rassenti and Vernon L. Smith
Richard Smith, Paula Lorgelly, Hareth Al-Janabi, Sridhar Venkatapuram and Joanna Coast
Richard S. J. Tol, Samuel Fankhauser, Onno J. Kuik and Joel B. Smith
Richard Eccleston, Richard Krever and Helen Smith
This chapter establishes the conceptual and theoretical foundations for the ensuing volume. It summarizes the debates concerning the key features of federal governance before providing an overview of the existing explanations of change in federal systems, with a particular emphasis on the application of new institutionalism to explanations of ‘federal dynamics’. The second section of the chapter focuses on the literature on the impact of financial and economic crises of federal governance before providing an empirical account of the economic impact of the 2008–9 financial crisis on the 12 cases included within the volume. The chapter concludes by outlining how an actor-centred institutionalism is applied to the case studies that follow.
Johanna Hanefeld and Richard Smith
A novelty of globalization, over previous centuries of internationalization of trade across borders, has been the increasing focus on services, in addition to primary and manufactured goods, which has been facilitated by advances in transport and telecommunications. While there are many services which impact upon health, over the past two decades there has been a considerable rise in trade in services directly related to healthcare and health systems; largely as a direct result of the development of the General Agreement on Trade in Services (GATS) by the World Trade Organization in the mid-1990s. This trade takes a number of different forms, including the cross-border provision of medical services, foreign direct investment in health services, movement of health workers across borders and, perhaps most prominently, ‘medical tourism’, where patients move to access services abroad and which is examined in greater detail in this Handbook. While the overall volume of trade in health-related services is not fully known, and data poses difficulties across the different types of travel, available data sources suggest that although health-related services represent only a small proportion of the overall trade in services, this is a significant growth area. This chapter reviews the different types of trade in health services as defined under the GATS agreement and discusses the relationship between these different modes.
Johanna Hanefeld and Richard Smith
Medical tourism is often associated with patients travelling for treatment to an exotic destination where they pay out-of-pocket for their treatment, received mainly in the private sector. Yet the term medical travel or tourism covers a range of different types of travel including where patients travel as part of government schemes purchasing medical services abroad, where patients return to their home country to receive treatment – often called diaspora patients, or cross-border areas which operate schemes allowing patients from different countries to access services. It also extends to where patients travel because they are unable to access a type of treatment at home or when a treatment is not accessible to them. This type of treatment, where there is less patient choice, is sometimes referred to as medical migration. In this chapter, the authors review different types of financing mechanisms used by patients travelling for treatment, and they explore how different types of financing mechanisms link to specific types of travel and industry models.