International health and aid policies of the past two decades have had a major impact on the delivery of care in low and middle-income countries. This book argues that these policies have often failed to achieve their main aims, and have in fact contributed to restricted access to family medicine and hospital care. Presenting detailed evidence, and illustrated by case studies, this book describes how international health policies to date have largely resulted in expensive health care for the rich, and disjointed and ineffective services for the poor. As a result, large segments of the population world-wide continue to suffer from unnecessary casualties, pain and impoverishment. International Health and Aid Policies arms health professionals, researchers and policy makers with strategies that will enable them to bridge the gaps between public health, medicine and health policy in order to support robust, comprehensive and accessible health care systems in any political environment.

Health service delivery is being restructured in many different ways in both the industrialized and developing countries. This process is set to accelerate as a result of diverse factors including fiscal pressure, privatization and the renegotiation of the WTO General Agreement on Trade in Services (GATS), with important implications for access and equity in the healthcare field. The contributors to this volume review the rapidly changing context of debates about financing health care and its relationship to globalization and privatization and examine the mechanisms and institutional processes involved. They explore four very different country experiences: the USA, where the creed of market competition and managed care in the health sector is most advanced; Western Europe, where reforms aimed at market competition and freedom of choice are taking place; developing countries, where the role of the state in healthcare delivery is being dramatically reduced; and Cuba, which shows what political commitment to public health can still achieve despite scarce resources.