Designing Effective Healthcare: Matching Policy Tools to Problems in China

Bali, Azad Singh; Ramesh, M.

doi:10.1002/pad.1781

Cited by 9 publications

(5 citation statements)

References 34 publications

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“…This concept is particularly salient in the health sector, which is well known for the multitude of market failures that require remedial interventions (Helderman et al, 2012). While this was a useful corrective to the 1990s discussions centred on sweeping generalisations about privatisation and marketisation and the subsequent discussions on superiority of collaborative governance, it overlooked many essential preconditions for effective health policy (Bali & Ramesh, 2015, 2017). Indeed, governments can use other policy tools that offer more regulation‐like effects than regulations.…”

Section: Health Policy Debates: Promise and Perilsmentioning

confidence: 99%

Active stewardship in healthcare: Lessons from China's health policy reforms

Bali

Ramesh

2022

Soc Policy Adm

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Governments across the globe have made repeated attempts to reform their health systems in recent decades with the purpose of improving access while containing costs. What is the role of government in contemporary health policy in achieving these somewhat contradictory goals? This paper conceptualises this role as one of "active stewardship" wherein the government is a central actor steering and coordinating the sector through a portfolio of diverse policy tools. In this conceptualisation, the government is not a passive participant-in merely financing, delivering, or regulating the sector-but a steersman at the helm that sets policy objectives and actively pursues them. We argue that active stewardship is central to achieving contemporary health policy priorities of universal healthcare.We apply this conceptualisation to China's recent healthcare forms and show that the role of the government in governing the sector has changed substantially over time, particularly since 2009, and the changes are showing promising results. China's experience suggests that governments need to more actively guide and shape the behaviour of both public and private players in order to achieve the goals of universal health coverage. It also suggests that a high degree of policy capacity is essential if active stewardship is to be effective.

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Section: Health Policy Debates: Promise and Perilsmentioning

confidence: 99%

Active stewardship in healthcare: Lessons from China's health policy reforms

Bali

Ramesh

2022

Soc Policy Adm

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“…The new design orientation has set up a tall order for effectiveness in program designs whereby designs must be coordinated, coherent, reduce contingent liabilities, and avoid Type 1&2 errors, among others (Bali & Ramesh, 2017 ; 2018 ; Howlett, 2018 ). For example, while network governance may be well suited to policy design for sensitive issues such as elderly care or parental supervision (Pestoff et al, 2012 ) in other situations, civil society may not be well enough organized or endowed in order to generate beneficial network modes of governance off-the-ground and without initial regulatory support (Tunzelmann, 2010 ).…”

Section: Policy Capacity Requisites For Effective Policy Design: Emermentioning

confidence: 99%

Policy capacities and effective policy design: a review

2021

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Effectiveness has been understood at three levels of analysis in the scholarly study of policy design. The first is at the systemic level indicating what entails effective formulation environments or spaces making them conducive to successful design. The second reflects more program level concerns, surrounding how policy tool portfolios or mixes can be effectively constructed to address complex policy objectives. The third is a more specific instrument level, focusing on what accounts for and constitutes the effectiveness of particular types of policy tools. Undergirding these three levels of analysis are comparative research concerns that concentrate on the capacities of government and political actors to devise and implement effective designs. This paper presents a systematic review of a largely scattered yet quickly burgeoning body of knowledge in the policy sciences, which broadly asks what capacities engender effectiveness at the multiple levels of policy design? The findings bring to light lessons about design effectiveness at the level of formulation spaces, policy mixes and policy programs. Further, this review points to a future research agenda for design studies that is sensitive to the relative orders of policy capacity, temporality and complementarities between the various dimensions of policy capacity.

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“…As new programs get designed through patching rather than repackaging it all together, the incremental change in the policy components mix may lead to a disorganized mix . To overcome this, the policy design must evolve, adapting to different contexts, balancing political and practical aspects, but the evolution process requires corresponding evolution in the policy capacity . Therefore, the capability to continuously adapt policy design is another critical determinant of policy effectiveness …”

Section: Effective Policy Design: What It Takes For a Policy To Be Efmentioning

confidence: 99%

“…44 To overcome this, the policy design must evolve, adapting to different contexts, balancing political and practical aspects, but the evolution process requires corresponding evolution in the policy capacity. 22,45 Therefore, the capability to continuously adapt policy design is another critical determinant of policy effectiveness. 22,46 Policy capacity is a set of competencies and capabilities necessary to perform policy functions-making and implementing intelligent choices as well as steering and weaving together relevant processes.…”

Section: Effective Policy Design: What It Takes For a Policy To Be Effectivementioning

confidence: 99%

Understanding public health insurance in India: A design perspective

Maurya

2019

Health Planning & Management

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Summary It is broadly accepted that health policy is crucially affected by contextual conditions. Yet, little is known about how the context limits the effectiveness of public health insurance (PHI) programs and the extent to which these limitations could be overcome. The objective of the paper is to address these issues on the basis of the examination of 17 PHI schemes introduced by federal and state governments in India since independence. Faced with the challenge of simultaneously expanding insurance coverage while containing costs, governments have overwhelmingly favored the latter. At the same time, governments have lacked the capacity to monitor performance, which has led providers to compromise quality in return for low payment rates. While there have been modest improvements in recent years, reform efforts have been hindered by contextual conditions that constrain the use of measures to control profiteering by for‐profit agencies. The paper argues that system‐wide data on the quality of providers (system‐level operational capacity) and the ability of public agencies to monitor quality and link it with payment (organizational‐level operational capacity) critically determined the program effectiveness. We demonstrate the interaction between contextual variables, program design elements, and policy capacity linking to performance, arguing for a broader approach to understand PHI performance. We extend the present frameworks on PHI effectiveness that have narrowly focused on the design of health financing functions without factoring unfavorable context and limited policy capacity in developing countries. The paper contributes to improving PHI performance operating in unfavorable contextual conditions in India and elsewhere.

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Designing Effective Healthcare: Matching Policy Tools to Problems in China

Cited by 9 publications

References 34 publications

Active stewardship in healthcare: Lessons from China's health policy reforms

Active stewardship in healthcare: Lessons from China's health policy reforms

Policy capacities and effective policy design: a review

Understanding public health insurance in India: A design perspective

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