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This paper proposes that if a political system is more like to facilitate a unified government, to establish a strong executive body and to respond to the needs of the majority, financial reforms are more likely to emerge from the policymaking process and produce positive results. On the contrary, political systems that discourage those governing features are less likely to produce reforms. This chapter compares financial reform processes in China, Taiwan and New Zealand. All of them performed low level of financial reforms in the early 1980s but resulted in different situations later. In the mid-2000s, New Zealand heralded the most efficient and stable financial system; while Taiwan lagged behind and China performed the worst. Evidence showed that China’s authoritarian system may be the most superior in forming a unified government with a strong executive, but the policy priority often responds more to the interests of a small group of power elites; therefore the result of financial reform can be limited. Taiwan’s presidential system can produce greater financial reform when the ruling party controls both executive and legislative bodies, but legislative obstructions may occur under a divided government. New Zealand's Westminster system produces the most effective and efficient financial reform due to its unified government and a strong executive branch with consistent and stable supports from the New Zealand Parliament.

Here is a new conceptual framework for organizational learning (OL) that applies to both planned reform and emergent change. It integrates strategic and operational, micro and macro perspectives. It has three parts: (a) a revised definition and typology of OL, (b) seven reform stories that define stages and tasks, (c) a management and assessment guide demarcating four areas of OL: (i) action learning within core operations; (ii) sharing learning and innovations across the organization; (iii) mission/s-beyond ambidexterity; (iv) integration-managing mission conflicts and other paradoxes, which ensure endogenous change. Dynamic capability is therefore intrinsic to this view of OL that is illustrated from two cases: NYPD and public school reforms.

Objective – The aim of the paper is to bring evidence and lessons from two low- and middle-income countries (LMIs) of the former USSR into the global debate on health financing in poor countries. In particular, we analyze the introduction of social health insurance (SHI) in Kyrgyzstan and Moldova. To some extent, the intent of SHI introduction in these countries was similar to that in LMIs elsewhere: increase prepaid revenues for health and incorporate the entire population into the new system. But the approach taken to universality was different. In particular, the SHI fund in each country was used as the key instrument in a comprehensive reform of the health financing system, with the new revenues from payroll taxation used in an explicitly complementary manner to general budget revenues. From a functional perspective, the reforms in these countries involved not only the introduction of a new source of funds, but also the centralization of pooling, a shift from input- to output-based provider payment methods, specification of a benefit package, and greater autonomy for public sector health care providers. Hence, their reforms were not simply the introduction of an SHI scheme, but rather the use of an SHI fund as an instrument to transform the entire system of health financing.

Methodology/approach – The study uses administrative and household data to demonstrate the impact of the reforms on regional inequality and household financial burden.

Findings – The approach used in these two countries led to improved equity in the geographic distribution of government health spending, improved financial protection, and reduced informal payments.

Implications for policy – The comprehensive approach taken to reform in these two countries, and particularly the redirection of general budget revenues to the new SHI funds, explain much of the success that was achieved. This experience offers potentially useful lessons for LMIs elsewhere in the world, and for shifting the global debate away from what we see as a false dichotomy between SHI and general revenue-funded systems. By demonstrating that sources are not systems, these cases illustrate how, in particular by careful design of pooling and coverage arrangements, the introduction of SHI in an LMI context can avoid the fragmentation problem often associated with this reform instrument.

This chapter investigates the origins of cross-sectoral collaboration by exploring when and why policy networks form within the Turkish health sector – a least likely case for network formation. The analysis presented here draws on information collected from a number of official documents, semi-structured interviews with professional experts, and two multi-stakeholder meetings. Timewise, networks entered the policy jargon during the introduction of the Health Transformation Program in 2003. Yet, the years between 2011 and 2015 were ground-breaking in producing concrete cross-sectoral collaborative instruments of policy making. The findings of the analysis reveal that policy networks form as a result of central government’s choice to devolve responsibility and expand the policy space with new issues and actors. Moreover, policy networks emerge not only during the times of policy change which has a reactionary, abrupt, and nature but also during the times of policy stability and legitimacy. These contextual factors are crucial in maintaining an atmosphere of trust among stakeholders, particularly between state and non-state actors. The refugee crisis and spreading securitization discourse in the post-2015 period explain the shifting policy and political agenda leading to public sector retrenchment from cross-sectoral projects within the field of health. This chapter intends to contribute to the literature of comparative public policy by examining the link between policy networks and policy change in addition to adding to the debates on network governance by exploring the processes of network formation. Finally, this chapter contributes to Turkish studies by examining the process of network formation within the Turkish health sector.

This study evaluates whether sociodemographic characteristics, political affiliation, family-related circumstances, self-reported health status, and access to health insurance affect public opinion toward the current US health-care system. Opinions about the health-care system were measured in terms of consumer confidence and perceived need for health-care reform. Data come from the 2008 Cooperative Congressional Election Study (CCES), a nationwide survey of 1,000 respondents. All data were collected in November 2008, thus providing a useful alternative to volatile polling data because they were collected prior to and are thus immune to the polarized tone of the debates that have occurred over the past few years. Overall, we found that public confidence in medical technology and quality of care were consistently high, while confidence in the affordability of medical care was much lower among respondents. Younger adults, those with poor health, and those without health insurance had particularly low confidence in their ability to pay for health care. Although a strong majority of the population agreed that the US health-care system was in need of major reform, support for particular types of government-sponsored health insurance programs was primarily determined by political affiliation. In an era where a large proportion of the population has little access to health care (due to lack of insurance) and where the US government is facing tremendous opposition to the implementation of major reform efforts, it is useful to understand which subgroups of the population are most confident in the current health-care system and most likely to support reform efforts, as well as those who are most resistant to change given their precarious health needs, their inability to access health care (as a result of insurance or noninsurance), or their political affiliation.

Health care organizations function in multidimensional environments, and their organizational cultures are complex and demanding. Expectations for health care services are high: patients want the most effective and newest possible treatments, politicians demand accountable service production, and health care professionals require motivating and challenging work environments. All these goals and objectives, for example, can be at the root of wicked problems in health care management. Thus, this chapter aims to explore the wickedness of health care management through an analysis of Finnish and Swedish health care reforms. The aim of these reforms is to solve the problems encountered in health care systems and organizations. The concept of a ‘wicked issue’ can shortly be described as a problem that is difficult to identify and solve. The reasoning behind using the concept of wicked issue as a method for analysis here is the hypothesis that the concept helps to explain and understand the social complexity involved in health care management.

This chapter looks at the experiments of the Aam Aadmi Party led government’s initiatives in building teacher quality for its government schools in the capital city. Outlining the contours of neoliberal influence on Indian education policy and its consequences on teacher quality, the chapter explores the political rationality that governs the case of Delhi. It does this by understanding the changing subjectivities of the school teachers within the educational reforms. The government schools in Delhi have been blamed for worsening school performance especially in student learning outcomes through basic educational tests conducted by various assessment and evaluation surveys. Among other reasons, poor teacher quality has been identified as one of the major causes of this poor performance of government school children. Therefore, gaps were identified in the teacher support system and efforts were made to revamp the system. The chapter brings out in detail how the state’s initiatives in educational reforms have produced paradoxical situations and unintended effects in practice as the state has retained a controlling role even though the reform strategies show a shift toward increasing autonomy and deregulation.