The Global Transformation of National Health Systems
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Development. Copyright © 1999 The Society for International Development. SAGE Publications (London, Thousand Oaks, CA and New Delhi), 1011-6370 (199912) 42:4; 76–77; 010928.
Negotiating New Health Systems
The Global Transformation of National Health Systems EDGAR BARILLAS
ABSTRACT Edgar Barillas discusses the factors contributing to the global transformation of national health systems, the consequences that it may have on the health situation of the population, and the new role that international organizations may have in this scenario.
Introduction The result of globalization is an increase in cross border economic, political and cultural flows leading to greater interdependence among formerly distinct nations. This process is affecting the health situation of the world population, and the way health systems are organized. Our generation is witnessing the emergence of global working classes living under the same conditions and the establishment of a health care system that is tightly connected. If there is no turning back on these trends, in the near future a global world order is going to make meaningless the use of countries for the comparative analysis of the health situation and the transformation of the health care systems. Global working classes and the health care services that they can access may be a more reliable source of information for the design of strategies leading to the eradication of inequalities. Most of the analysis presented here is based on the projection and interpretation of current trends, and the construction of a vision of the future that is feasible. Some of these hypotheses demand empirical confirmation. Strong evidence is needed to show that the ongoing process of globalization of national health systems will, indeed, tend to form a new transnational order of health care. The triggering events leading to a global health care system are presented in this article. International division of work One of the most immediate and evident causes and implications of globalization is an international division of work, not among countries but within each one,
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Barillas: Transformation of National Health Systems dividing the world population into relatively homogeneous working groups. Evidence suggests that the productive structure is turning global, and so is the working force. With the expansion of multinational companies and the demand for minimal working conditions and rights, the globalization of living conditions is an inevitable event. Since living conditions are the most important factor influencing the health profile of a social group, it is predictable that a peasant, no matter where he works, may have a similar life expectancy, and die for the same reasons. Migrations Globalization has increased international migrations and the speed of communications. These factors are at least partially responsible for the rapid spread of cholera in Latin America and AIDS around the world. Tourists and migrant worker flows have contributed to the spread of i
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