How do courts set health policy? The case of the Colombian Constitutional Court.
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ABSTRACT:
SUBMITTER: Yamin AE
PROVIDER: S-EPMC2642877 | biostudies-literature | 2009 Feb
REPOSITORIES: biostudies-literature
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How do courts set health policy? The case of the Colombian Constitutional Court.
Yamin Alicia Ely AE Parra-Vera Oscar O
PLoS medicine 20090201 2
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Project description:Judicial diplomacy describes the courts’ efforts to promote liberal democracy and protect their institutional authority. Bilateral court meetings are essential for judicial diplomacy, encompassing jurisprudential (e.g., discussion of case law) and aims of strategic (e.g., maximising influence). This study presents a novel approach to assess such meetings. It analyses the German Federal Constitutional Court meeting reports between 1998–2019, using content and semantic network analysis. The content analysis shows that court meetings focus on jurisprudential aspects; however, strategic considerations also play a role in discussions with interlocutors from emerging democracies. These findings are substantiated by the semantic network analysis, which discloses that recent case law, Europeanisation, and globalisation are the main issues discussed. Hence, this study presents an analysis of a novel data source. Further, it contributes to judicial politics research as transnational court meetings could be a missing link to understand legal citation networks. Supplementary Information The online version of this article (10.1007/s12286-021-00499-0) contains supplementary material, which is available to authorized users.
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Project description:The high cost of drugs for hepatitis C limits access and adherence to treatment. In 2017, the Colombian health care system decided to design a strategy. It consisted of centralized purchasing, regulations, clinical practice guidelines, and direct observation of the treatment and follow-up of patients. The main objective of this study was to assess the centralized purchasing strategy in Colombia. The study design was a policy implementation assessment. We analyzed the change in prices, the clinical outcomes, and the opinions of stakeholders using data from the Ministry of Health. Additional information about effectiveness came from the Colombian Fund for High-Cost Diseases and semi-structured interviews of the stakeholders. The follow-up was from October, 2017 to October, 2018. The total number of patients reported in the cohort period was 1069. The number that finished 12 weeks of treatment, completed the follow-up for the case closure, and were considered cured through the end of October, 2018 was 563 (53%). The remainder, 506 patients (47%), are currently in treatment. A total of 543 of these treated patients (96%) were cured. After implementing this strategy, the drug prices decreased by more than 90% overall. Before implementation, the total direct cost was $100 102 171.75 dollars. Afterward, the cost was $8 378 747 dollars.
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Project description:How does the public assess the Supreme Court and its work? Using data from three surveys conducted over a span of ten years, we show that individuals' policy preferences drive evaluations of the Court and its willingness to reform the Court. We find strong evidence that the Court's hybrid legal-political nature enables a unique form of policy-motivated reasoning: respondents who agree with Court outputs view the Court and its work as more "legal" in nature, while those who disagree view both as more "political." Our findings stand in contrast to longstanding views in the literature that the public views the Court as a fundamentally different sort of institution that stands largely separate from politics. The fact that policy attitudes powerfully inform the public's assessment of the Court has crucial implications for the ongoing debates over Supreme Court power.
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Project description: Not available
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Project description:This study explores politically motivated reasoning among U.S. Circuit Court judges over the past 120 years, examining their writing style and use of previous case citations in judicial opinions. Employing natural language processing and supervised machine learning, we scrutinize how judges' language choices and legal citations reflect partisan slant. Our findings reveal a consistent, albeit modest, polarization in citation practices. More notably, there is a significant increase in polarization within the textual content of opinions, indicating a stronger presence of motivated reasoning in their prose. We also examine the impact of heightened scrutiny on judicial reasoning. On divided panels and as midterm elections draw near, judges show an increase in dissent votes while decreasing in polarization in both writing and citation practices. Furthermore, our study explores polarization dynamics among judges who are potential candidates for Supreme Court promotion. We observe that judges on the shortlist for Supreme Court vacancies demonstrate greater polarization in their selection of precedents."I pay very little attention to legal rules, statutes, constitutional provisions ... The first thing you do is ask yourself - forget about the law - what is a sensible resolution of this dispute? ... See if a recent Supreme Court precedent or some other legal obstacle stood in the way of ruling in favor of that sensible resolution. ... When you have a Supreme Court case or something similar, they're often extremely easy to get around." (An Exit Interview with Richard Posner, The New York Times, Sep. 11, 2017).
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Project description:We report on a unique Italian criminal case in which a court ruled that a therapist implanted false memories of abuse in a young girl. Using therapeutic excerpts, we show that the therapist used a multitude of problematic interventions that are all linked to false memory creation. Specifically, an analysis of the therapeutic excerpts showed that across many sessions, the therapist asked highly suggestive questions to the girl, implying that she was abused by her father. In addition, the girl underwent EMDR techniques that have been associated with memory undermining effects. Our analyses showed that although before treatment the girl did not have any recollection of being abused by her father, she gradually started to remember the abuse and identified the father as her abuser during the therapeutic sessions. Our case report clearly shows the danger of suggestive pressure in a therapeutic context causing patients to form false memories of abuse and supports the need to prevent the therapeutic practice of suggestive techniques.
| S-EPMC9544012 | biostudies-literature
Project description:We use the concept of judicial reliance to describe the willingness and extent to which citizens seek the help of the court in a dispute. There are obvious local differences in the degree of judicial reliance in different provinces, with some citizens more willing to resort to the courts to settle disputes, whereas others are indifferent to the courts. Based on the judicial survey data of 31 provinces in China, we use fuzzy-set qualitative comparative analysis to explore the possible reasons for differences in citizens' judicial reliance in China. We find that citizens' judicial reliance is deeply influenced and restricted by five judicial conditions: transparency, corruption, independence, procedure, and professionalism. These causal conditions influence and interact with each other, thus forming six configurations that produce high judicial reliance. Among these six configurations, judicial professionalism is always the core condition. In recent years, China has indeed attached great importance to the construction of judicial professionalism, which not only optimizes the quality of the internal personnel of the court but also strengthens the public's recognition of the court.
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Project description:IntroductionAchieving universal health coverage (UHC) through an effective health financing system is a challenge for many low-income countries. Learning is key to success due to many uncertainties and unknowns. Using the case of translating strategic health purchasing into policy and practice in Burkina Faso, our study seeks to understand how policy learning can shape policy processes and outcomes.MethodsWe used a qualitative case study design and Dunlop and Radaelli's conceptualisation of policy learning to identify which modes of learning did or did not occur, what helped or hindered them and the resulting policy outcomes. Dunlop and Radaelli frame policy learning as epistemic, reflexive, negotiative or hierarchical. We collected data through documentary review and in-depth individual interviews with 21 key informants. We analysed the data manually using pattern-matching techniques.ResultsThe introduction of strategic health purchasing in Burkina Faso was initially seen as an opportunity to reduce the fragmentation of the health financing system by coupling a performance-based financing scheme and a user fee exemption policy. However, this has faltered, and our findings suggest that an inability to harness all modes of learning has led to blockages. Indeed, while reflective learning was present, epistemic, hierarchical and learning through bargaining were absent, preventing national policy actors from defending their own policy or scheme from reaching compromises. But thanks to facilitating processes led by a well-resourced organisation and contextual elements that encouraged the emergence of more pluralistic modes of learning, some progress was achieved in operationalising strategic health purchasing.ConclusionsSome modes of learning seem to be overlooked in countries' efforts to achieve UHC. Facilitation techniques and initiatives that encourage the use of all modes of learning, while supporting countries to take full ownership and responsibility for consolidating their own learning health systems, should be promoted.
| S-EPMC11575319 | biostudies-literature
Project description:BackgroundTo progress towards universal health coverage (UHC), each country will have to develop its systemic learning capacity. This study aims at documenting how, across time, learning can feed into a UHC policy process, and how the latter can itself strengthen (or not) the learning capacity of the health system. It specifically focuses on the development of a major health financing policy aligned with the UHC goal in Morocco, the RAMED, a health financing scheme covering hospital costs for the poorest segment of the population.MethodsWe conducted a retrospective analysis of the RAMED policy for the period between 1997 and 2018, along with a case study design. For the data collection and analysis, we developed a framework combining Garvin's learning organisation framework and the heuristic health policy analysis framework. We gathered data from key informants and document reviews.ResultsThe study confirmed the importance of learning during the different stages of the RAMED policy process. There is evidence of a leadership encouraging learning, the introduction and adoption of knowledge management processes, and the start of a transformation of the administrative culture. Yet, our study also showed some major shortcomings, especially the lack of structure of the learning, and insufficient effort to systemise and sustain a transformation of practices within the health administration. Our study also confirms that the learning changes in nature across the different stages of the policy process.ConclusionThe policy decisions and the implementation strategy create a learning dynamic, though not structured in all cases. Despite the positive interaction between learning and the RAMED policy, the opportunity to push forward a more structural transformation towards a learning system has not been fully seized. Hierarchical logics still largely prevail in the Moroccan health administration. The impact of future health policies for both the target beneficiaries and the health system will be bigger if their design integrates purposeful and structured actions in favour of organisational learning. This recommendation probably applies beyond Morocco.
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Project description:The Health Level 7 (HL7) organization introduced the Information Sensitivity Policy Value Set with 45 sensitive data categories to facilitate the implementation of granular electronic consent technology. The goal is to allow patients to have control over the sharing of their sensitive medical records. This study represents the first attempt to explore physicians' viewpoints on these categories. Twelve physicians participated in a survey, leading to revisions in 21 HL7 categories. They later classified 600 clinical data items through a second survey using the updated categories. Participants' perspectives were documented, and data analysis included descriptive measures and heat maps. In the first survey, six participants suggested adding 19 new categories (e.g., personality disorder), and modifying 25 category definitions. Two new categories and sixteen revised category definitions were incorporated to support more patient-friendly content and inclusive language. Fifteen new category recommendations were addressed through a revision of category definitions (e.g., personality disorder described as a behavioral health condition). In the second survey, data categorizations led to recommendations for more categories from ten participants. Future revisions of the HL7 categories should incorporate physicians' viewpoints, validate the categories using patient data or/and include patients' perspectives, and develop patient-centric category specifications.
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