PLANNING: LESSONS FROM THE U.S.S.R. |
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| Authors: | Raisa B Deber |
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| Institution: | RAISA B. DEBER (Ph.D., M.I.T.) is Assistant Professor in the Department of Health Administration at the University of Toronto, with a cross-appointment in the Department of Political Economy. Her research interests are in Canadian politics and in comparative health policy. She is currently studying medical decision making for end-stage renal disease as a model for the adoption of new technologies. |
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| Abstract: | Evaluation of the success of a plan requires the collection of statistics and indicators for monitoring purposes. In the health care field, outcomes are notoriously difficult to measure. To the extent that a successful program of prevention should result in providing less of a service, a conflict exists between planning and prevention: in the absence of outcome measures, success will be indistinguishable from failure, as in both cases, planned targets would not be met. To avoid this dilemma, an indicator-oriented planning system would be predicted to operationalize prevention in countable terms requiring increased inputs, or increased numbers of processes, regardless of the payoffs in health benefits. Screening, check-ups, and one-on-one contacts with health professionals would be emphasized at the expense of group-oriented activities or societal changes. Planning can thus have counter-productive policy implications. This theory is illustrated by reference to the current health care system in the U.S.S.R., including their anti-smoking and anti-alcoholism programmes. |
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