WHO''s health futures consultation

The World Health Organization's 1993 consultation on health futures examined the field from perspectives of the macro-environment, health status, health resources, emerging health technology, alternative care systems, and tools for health futures research. The consultation produced numerous suggestions about how WHO could promote and support health futures work. Among the ideas now being implemented are new efforts in global surveillance of infectious diseases, the publication of health futures articles, the establishment of an electronic health futures bulletin board, and preparation of a handbook for health futures studies.     

What future for health futures in Latin America and the Caribbean?

The Pan American Health Organization (PAHO), Regional Office of the World Health Organization, is a United Nations agency specializing in providing technical cooperation in health to the countries of Latin America and the Caribbean. A futures approach has much to offer in this endeavour, and PAHO is making health futures tools available to its Member States through a variety of activities. The purpose of promoting futures thinking and the application of futures tools is to improve health-policy planning and public health action within the framework of the ‘Health for All’ vision and PAHO's current Strategic and Programmatic Orientations.     

Beyond medicine : Health challenges and strategies in the 21st century

The future of health involves much more than the future of medical care since the major factors affecting health are environmental, social and economic ones. Health has generally improved in the past century, but the continuation of this trend is threatened by population growth, urbanization environmental change, poverty, inequity, war, existing communicable and chronic diseases, and possible new ones. New policies and strategies emerging to deal with these challenges include the formulation of healthy public policy, investing in health, and the development of new structures and processes of governance. Integrated national studies focused on human well-being and environmental health are one means through which the futures field could contribute to the improvement of health in 21st century. Visioning workshops and other participatory futures activities are equally important, since they enable people and communities to take part in the definition and achievement of their preferred health futures.     

Some practical hints for newcomers to health futures

The three authors of this article are all relative newcomers to the health futures field. One is based within an academic Institute of Public Health, another at the regional tier of the UK National Health Service (NHS), and the third within the NHS Executive Headquarters. The common bond between them is a desire to contribute to the development of new ways of planning for health and a wish to see health futures actively engaged with health services to bring about effective change. With the aim of providing practical advice for others who are beginning to take an interest in health futures work, they look back on their own personal experiences and summarize the lessons they have learned.     

A vision for Nicaragua : Health services in the new century

Nicaragua is facing a crisis in health and health care, and a health futures programme has been initiated to focus concern and mobilize key actors. Two national scenario workshops have been held at which participants constructed several scenarios describing alternative health futures for the country, with particular emphasis on the organization of health services. One or these, a scenario of profound change, was selected by the participants as their vision of the preferred future. It involves more emphasis on health promotion, decentralization of health-care services, broader participation in health matters, improved training for health professionals, and a stronger role for universities and other educational and research centres. Implications of the selected scenario regarding health policies and actions have been identified, among them being the adoption and implementation of the Ottawa Charter on Health Promotion, the organization of local health service networks, and the more active involvement of health professionals in the designing of health systems.     

The future of futures decision making

At the dawn of a new millennium, with the past one thousand years ready for reflection and the up-coming one thousand years primed for exciting new adventures, humankind seems to be trapped in the box of myopic, short-term decision making. Voices pleading to expand the horizons of our decision making to ensure sustainability of our species and countless other species on this earth are currently drowned out by a cacophony of voices trumpeting economic globalization, rapid technology development, and real-time financial markets. While futures decision making is not much in evidence today, the question addressed by this paper is whether futures decision making is even possible. Are there inherent constraints in our ability to make decisions that encompass time frames covering centuries if not millennia? An enormous amount of research has been conducted in the general area of decision making over the past several decades. Much has been learned about the psychology of human decision making and decision making within organizations. Countless methods have been developed to guide decision making. Recent work in areas such as imprecise probability and complex adaptive systems is beginning to provide boundaries as to what can be known about the future. This paper reviews much of this diverse literature and synthesizes important research findings across several disciplines to identify numerous significant barriers to futures decision making. The paper presents several recommendations on how to improve futures decision making in the future.     

Health trend assessment in Indonesia Futures studies at the provincial level

Health trend assessment studies have been carried out in Indonesia at the national and provincial levels, to provide input into long-term national development plans and to build up the capacity for local health planning in anticipation of decentralization. Provincial health trend assessment studies have been done in five provinces by teams from local health and planning authorities and the local school of public health. These provincial teams have all used background documents and standard procedures developed by a national team and have gone through the same methodological training. Out of the experience have come specific ideas about how trend assessment and similar activities can be strengthened. Among the recommendations are the establishment of national research centres for trend analysis, efforts to improve availability and reliability of relevant data, the training of a cadre of health professionals familiar with futures methods, and continued promotion by WHO and other agencies of long-term health planning and health futures.     

Narrative foresight

Narrative foresight focuses on the stories individuals, organizations, states and civilizations tell themselves about the future. Narrative foresight moves futures thinking from a focus on new technologies and generally to the question of what’s next, to an exploration of the worldviews and myths that underlie possible, probable and preferred futures. It is focused on transforming the current story – metaphor or myth – held to one that supports the desired future. From a theoretical account of the narrative turn, case studies are presented of the practice of narrative foresight.     

“Every today was a tomorrow”: An integral method for indexing the social mediation of preferred futures

The visions we hold of the future, whether they are of utopias or dystopias, are not simply a matter of personal imagination. Our conceptions of the future are mediated to us as much as they are privately created by us. To this point, futures studies have not developed an integrative and broad-based framework for considering the social mediation of futures. Understanding how social mediation impacts on our futures visioning requires an interpretive framework that can cope with the multilayered nature of futures visions, the worldviews that are associated with them and a theory of mediation that can be applied within such a context of ‘depth’. Using theory-building methodology, the current paper attempts this task by describing a theory of social mediation that builds on the integral futures framework. An application of the framework explores the relationship between various scenarios of health care futures, their associated worldviews and the mediational factors that influence our visions of future health care systems.     

证券期货市场人工智能交易的刑法规制

证券期货市场人工智能交易具有强大的预测分析能力、投资策略制定能力以及敏锐的市场反应能力。与之相适应,刑法对证券期货犯罪的规制重点也应当从交易的行为方式向交易技术转移。鉴于利用人工智能交易可以实施滥用技术优势型市场操纵犯罪行为,刑法有必要对人工智能交易予以规制,并且这种规制利大于弊。规制应当明确区分人工智能交易的正当使用和滥用,并进一步完善操纵证券、期货市场罪的规定。     

The International Health Futures Network (IHFN)

The International Health Futures Network (IHFN) provides an opportunity for those oriented towards health futures research, leadership and strategic policy-making to discuss the future of health and health care, share new ideas and visions and deepen their understanding of international health-care issues. IHFN members are committed to an ambitious vision of “improving health status worldwide by applying and advancing health futures”.     

Delphi in a future scenario study on mental health and mental health care

The article highlights methodological issues of futures research on mental health (care). In particular the limited relevance of quantitative psychiatric epidemiology is emphasized. The mental health sector in the Netherlands is characterized as a balance of power between professionals, institutions, insurance companies, patient organizations and local and national governments. To value shifts in this balance and to assess future interventions and policies, opinions of people who know the sector well are indispensable. Delphi with its main characteristics of anonymity, iteration and feedback to the participants and being a predominantly qualitative method for data collection was chosen to gather this type of information. Finally the Delphi method as a tool in policy-oriented futures research is discussed. The strength of Delphi must be found in its capacity to generate new options for intervention and to enhance consciousness of the future in order to reinforce rationality of decision processes. Clarifying dissensus on the issues under study proved to be as relevant as the elucidation of consensus.     

HIPAA's privacy rule: what is it, and how does it affect you?

This article discusses the implications for stakeholders of the privacy rule under the Health Insurance Portability and Accountability Act of 1996, on which the U.S. Department of Health and Human Services first released guidance on July 6, 2001. Although guidance will continue to evolve, the authors urge organizations to initiate the implementation of policies to ensure compliance by the actual effective date of 2003. (Small health plans have until 2004 to comply.)     

The hospital: how will it survive?

The federal government is under pressure to implement and enforce a program to provide economic and social relief from the rapidly escalating health care costs which now consume 8.5% of the Gross National Product. Glick predicts that within the next twenty years, the character of health care institutions will be reshaped and only the most adaptable hospitals, health maintenance organizations and health-related governmental organizations will survive. He urges hospitals to develop appropriate strategies to deal with the problems of cost-containment, state-operated cost review and control agencies, and the competition for limited health care resources. The author warns the health care industry that if it does not adjust to these changes, it runs the risk of becoming heavily rgulated. It is suggested that health care institutions be integrated into comprehensive health care systems and the article includes a model for assigning patients to medical care facilities on a regional basis. Glick forecasts that hospitals will enter into a competition for survival, resulting in mergers of some and the closing of others. He believes that as the number of health care institutions decreases, the remaining ones will become more specialized and geographically dispersed.     

A community of futurists and the state of the futures field

Criticisms of futures studies ought to be evaluated in comparison with those of other fields. For example, compared to the established disciplines, futures studies is less fragmented and has many positive features. Also, controversies among futurists do not mean that futures studies is not a field. Rather, one hallmark of any field of inquiry is that its members constitute a disputatious community. Moreover, futures studies is unified by interlinked and overlapping networks of communications and influences among futurists, a shared transdisciplinary matrix, and the growth of a futurist canon. The future of futures studies is bright, because it is reasonable to hope that futurists will be able to establish the field in most of the world’s colleges and universities.     

模糊厌恶下股指期货风险对冲策略设计及实证分析

投资者对股指期货与现货有着不同的模糊厌恶,本文首先将此假设条件引入带交易成本的Garleanu and Pederson (2013)投资模型中,并以指数基金对冲策略为例,构建了一个股指期货动态对冲的理论模型。与非对冲策略相比,基于上述模型设计的对冲策略投资绩效更好,动态最优成交额占目标交易额的比例更小,目标成交额对收益率预测因子的敏感性更大。借助上述模型,本文选取2010年4月至2021年6月的中国ETF指数基金和股指期货数据,并以2015年9月股指期货管理措施实施为界进行区间划分,实证研究发现:(1)中国A股市场的ETF投资组合进行股指期货对冲显著提升了投资绩效,但股指期货管理会削弱该作用;(2)投资绩效改善主要来源于交易成本的下降与目标成交额因子敏感性的提升,该机制受到股指期货管理的约束;(3)与Garleanu and Pederson (2013)、Zhang et al. (2017)相比,本文对冲策略保留“抗跌”特点的同时增加了“易涨”特性。本文研究结果表明,在当前大力发展机构投资者的背景下应不断丰富股指期货、股指期权产品谱系,降低股指期货交易成本并完善持仓约束。     

Health systems futures: The challenges of technology,prevention and insurance

This article argues that the futures of health systems depend on how countries address three wider challenges that include: (a) the adoption of health innovations and quality improvements, (b) responses to new non-communicable and preventable global diseases, as well as (c) adjusting financial models to current insurance constraints. Future trends point towards an increasing dependence on productive quality improvements, the personalisation of health care and the organisation of delivery and finance to take advantage of existing knowledge. Prevention, and disease avoidance, particularly that of non-communicable diseases, will aim to reduce pressure on “care components” of the health system whilst global control of communicable risks will become apparent. Finally, trends suggest an increase in patient participation and personalisation of insurance contracts will help to realign risk sharing with cost containment and financial sustainability. Other potential challenges such as ageing are regarded as second order issues to be addressed through these aforementioned future trends.     

Evolutionary theory in public health and the public health of evolutionary theory

Evolutionary theory is the most powerful explanatory system in the life sciences and is the only framework that can unify knowledge in otherwise disparate fields of research. Considerable advances have been made in the application of evolutionary biology to health issues in recent decades. Health researchers and practitioners could benefit considerably from an understanding of the basic principles of evolution and how humans have been shaped by natural and sexual selection, even if they are not explicitly testing evolutionary hypotheses. Life History Theory is a powerful framework that can be used for examining modern human environments and developing environments that maximize opportunities for positive health outcomes. Many of the recommendations derived from this framework converge with the visions of current public health advocates. Despite the benefits of an evolutionary framework, the challenges that face those attempting to integrate evolutionary theory into public health are perhaps greater than those in the social sciences. Although considerable advancements in the understanding of health issues have already been made, health researchers with an evolutionary perspective are very few in number and face constraining disciplinary attributes. Advances in medical technology will continue to extend the boundaries of saving lives in danger, however traditional public health efforts may be reaching their limits of effectiveness in encouraging health-promoting behaviors. This may partially account for the current interest in broad social and policy change to enhance health and reduce health disparities amongst sub-populations. Such substantial physical and social restructuring will face many challenges and gradual progress may be enhanced by a strong foundation of evolutionary human science. The slow but eventual integration of evolutionary principles will gradually enhance the effectiveness of health interventions and provide an ultimate explanation for patterns in health outcomes that are otherwise puzzling. The speed at which the field of public health adopts a Darwinian framework has yet to be determined, and several futures are possible. This pace will depend on several factors, including the visible utility of evolutionary theory for addressing the health promotion goals of the field.     

Health care fraud control: understanding the challenge

The study summarized here examined the fraud-control apparatus currently used within the health care industry, and assessed the assumptions, policies, and systems that constitute the industry's current approaches to fraud control. The objective was to develop a better understanding of the strengths and weaknesses of existing approaches. Since 1992, with Health Care Reform under debate, the issue of health care fraud has received unprecedented legislative and administrative attention. Nevertheless disturbing and somewhat surprising lapses in control persist. The fraud problem shows no sign of abatement. Background knowledge of the health care fraud issue was derived from literature searches and from four years of interaction with concerned public and private organizations. Fraud control systems, policies and procedures were examined in detail at eight field sites, representing a cross section of private, not-for-profit, and public programs. The National Institute of Justice funded the study under grant number #94-IJ-CX-K004. This study finds the science of fraud control scarcely developed and little understood by industry practitioners. Academia has paid little attention to the problem. Within the health care industry, the task of fraud control is complicated by the social acceptability of insurers as targets, the invisible nature of most fraud schemes, the separation between administrative budgets and "funds", the respectability of the health care profession, and the absence of clear distinctions between criminal fraud and other forms of abuse. Existing approaches to control are more effective in controlling billing errors, overutilization, medical unorthodoxy, and other forms of abuse than in dealing with criminal fraud. The complexity of the fraud control challenge is seriously underestimated by the health care industry Existing control systems are not targeted on criminal fraud and cannot be expected to control it. Scientific measurement of the fraud problem is a prerequisite effective control.     

The future of health futures : Another perspective

A good ‘market’ for health futures and easy access to relevant information are among the reasons that health futures is currently centred in the wealthy nations. Interest in health futures is growing in the less developed countries, however, in part because of efforts by WHO and its regional office. Many benefits can be expected if the field becomes more international, including an influx of fresh ideas about health futures study designs and about innovative approaches to health care. A shift to a more global orientation is also imperative simply because health futures deals with the well-being of human beings, and most human beings live in the less developed countries of the world.