Adolescent Bariatric Surgery: The Canadian Perspective

Canada faces a similar epidemic of obesity in their adolescent population as other Western countries. However, the development of programs to treat obesity and manage its sequelae has evolved in a unique way. This is in part due to differences in health care funding, population distribution, public demand, and availability of expertise and resources. In this article, we will describe the evolution of adolescent bariatric care in Canada and describe the current programs and future directions. The focus will be on the province of Ontario, the site of the first adolescent bariatric program in the country.     

基于“4E”理论对单一保险人模式下全民医保分析——台湾地区健保制度的经验启示

本文根据“4E”理论,从经济性、效率性、效益性、公平性4个维度,基于台湾地区健保制度实践,客观分析单一保险人模式下全民医保制度优劣势,认为其短期内能够为所有人提供公平、可及且一致的给付项目和保障待遇,并能有助于降低管理成本和控制医疗费用的不合理增长;但长期内作为官僚体制产物的健保署对医药服务市场的不适当约束将会导致医疗服务或药品短缺,同时,单一的筹资渠道和相对固定的费率也难以避免财务危机的到来。建议大陆全民医保一体化改革中要充分发挥单一保险人的优势,规避劣势。     

The 2019 introduction of the new National Healthcare System in Cyprus

In 2019, Cyprus launched its new National Healthcare System (NHS) as one of the major structural reforms required by the bail-out agreement with the International Monetary Fund, the European Commission and the European Central Bank (known as the Troika) which averted Cyprus bankruptcy in 2011. This paper presents the key features of the new NHS: A National Health Insurance Fund operated by the Health Insurance Organisation pays for services provided by a mix of public and private providers. A prerequisite for the establishment of this new quasi-market was the transfer of public hospitals from the Ministry of Health to the new State Health Services Organisation, thus establishing a purchaser-provider and regulator split. The first implementation phase started in June 2019 and introduced coverage of outpatient healthcare services for the entire population, providing access – with relatively small user charges – to family physicians, outpatient specialists, pharmaceuticals and laboratories. The second implementation phase began in June 2020 with the inclusion of hospital care, followed by the inclusion of specialty pharmaceuticals in September and was completed in December 2020. The reform is a vital achievement as it is a major step towards the goal of universal health coverage, reducing the excessive reliance on out-of-pocket payment and glaring inequities in access to care.     

湖南省肺结核门诊辅助诊疗单病种付费的可行性研究

目的 探索肺结核门诊辅助诊疗单病种全额付费在湖南省实施的可行性。方法 通过问卷调查和电话访谈的方式,了解全省131个县（市、区）肺结核门诊医疗保障的现状;通过现场访谈的形式,调查10个县（市、区）新型农村合作医疗（简称“新农合”）部门和疾病预防控制机构（简称“疾控机构”）共40名工作人员对“单病种付费”实施利弊的看法。结果 湖南省131个县（市、区）中有118个将肺结核门诊纳入了新农合报销,报销方式分为按比例报销、按额度报销和按病例包干定额付费3种,但报销比例（30%～80%）和额度（每例200～1500元/年）存在较大差别;根据省级指导标准,全省各非试点县（市、区）尚需每年增加1014万元肺结核门诊医疗保障。调查的6个试点县中,2个县试点前后基金负担无明显变化（增加幅度介于－5%～5%）,3个县略有增加（增加幅度介于5%～10%）,1个县显著增加（增加幅度10%以上）。 结论 肺结核门诊辅助诊疗单病种付费政策可以因地制宜地在湖南省逐步推广实施。