Health Systems Structure and Liberty

That health systems worldwide need to perform better is not in dispute. How best to measure this performance is what is somewhat contentious. It is clear that most of the routine decisions that determine the performance of health systems occur in treating specific diseases. It is reasonable, therefore, to examine treatment trends and health outcomes by disease and appraise health systems’ performance at the disease level, a bottom-up rather than the customary top-down approach that touches the hub of health system performance and that of the fundamental principles of liberty as they coalesce with the elements of healthcare delivery. We would in the process, see how considerable variations in disease management exist, due to significant differences in the structural characteristics of health systems even within jurisdictions such as in the use or otherwise of inducements, in policy formulation and implementation, and in the nature and extent of regulations influencing doctors to treat a specific disease some way. We would appreciate the consequences, not just for the quality of service provision of these variations but also for equity in healthcare access, and its implications for our current formulations of the concept of liberty, its sustainability as they stand, and the changes they would likely undergo in the years ahead, among others.

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