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008 | 101208s2010 xx ||||gr |0|| 0 eng d | ||
100 | 1 |
_98711 _a Radin, Beryl A. |
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245 | 1 | 0 | _aWhen is a health department not a health department? The case of the US department health and human services |
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_aOxford : _bWiley-Blackwell, _cApril 2010 |
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520 | 3 | _aGiven the current policy debate over health reform in the United States, it is not possible to describe the organizational structure that might emerge from this process. This article explores five of the attributes that underpin the context for a discussion of the structure and operation of a health bureaucracy in the USA. First, ambivalence in the US society about a public commitment to health and a general scepticism about a significant public sector in this area. Second, separation within the system between types of activities (e.g. health research activities, provision of services, and financing of health efforts). Third, the health system operates in the context of a government with shared powers as well as federalism and an assumption that some issues belong to states, and sometimes localities, and not to the federal government. Fourth, difficulty in the US system when it attempts to focus on prevention activities. And fifth, the structure of HHS creates tensions between management initiatives and professional expertise and standards. The article concludes with a discussion of possible organizational alternatives | |
773 | 0 | 8 |
_tSocial Policy & Administration _g44, 2, p. 142-154 _dOxford : Wiley-Blackwell, April 2010 _xISSN 01445596 _w |
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_a20101208 _b1205^b _cJaqueline |
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_a20110119 _b1144^b _cCarolina |
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_aConvertido do Formato PHL _bPHL2MARC21 1.1 _c37651 _d37651 |
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041 | _aeng |