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Contents
3. Improving Health: The Heart of the Matter
69
The Main Source of the Life Expectancy Gap Is Cardiovascular Disease 72 Smoking, Drinking, Men, and Women: More Can Be Done to Address Tobacco and Alcohol Use 79 There Are Big Gaps in Managing Risk Factors through Primary Care 91 The Quality of Treatment and Care for Key Conditions Is Often Poor 99 References 104 4. Improving Financial Protection and Equity: A Safety Net for All The Problem with Out-of-Pocket Payments: Conceptual Issues A Greater Reliance on Out-of-Pocket Payments Results in More Catastrophic Payments and Higher Inequality Better Financial Protection Depends on Adequate Health Budgets and Control of Rent Seeking References 5. Improving Efficiency: Cutting the Fat
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117 125 137 141
Judging Budgets: The Costs and Benefits of Government Health Spending Hospitals and Pharmaceuticals Are the Main Sources of Waste Cutting the Fat but Not the Muscle References
149 154 158
6. Improving Institutions: Ingredients, Not Recipes
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A Brief History of Health Reform in ECA since the Transition Where Are We Now? A Comparison of ECA and OECD Health Systems Ingredients, Not Recipes, for Successful Health Reform References 7. Summary Q&A
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