Political Strategies for Health Reform in Turkey: Extending Veto Point Theory

Sparkes, Susan; Bump, Jesse B.; Reich, Michael R.

doi:10.1080/23288604.2015.1093063

Cited by 22 publications

(20 citation statements)

References 16 publications

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“…He ultimately needed to call on the Prime Minister to transfer the social security hospitals, managed by the Ministry of Labor, to the Ministry of Health in a sudden and strong political move. 30 Example The three social security institutions were funded through a combination of payroll taxes, employer contributions, and general government tax revenues. There was also a Green-Card Program for the unemployed and informal workers.…”

Section: Leadership Politics ("Managing Up")mentioning

confidence: 99%

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Political Analysis for Health Policy Implementation

Campos

Reich²

2019

Health Systems & Reform

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148

110

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Introduction Methods Conceptual Framework Managing the Stakeholders of Policy Implementation Conclusions References ABSTRACT-Any effort to improve health system performance must address the challenges of policy implementation. This article examines one aspect of implementation-the politics of policy implementation for the health sector, particularly the management of stakeholders in order to help change teams improve the chances of achieving policy objectives. Based on a literature scan of political analyses and descriptions of health policy implementation in low-and middle-income countries, we propose six major categories of stakeholder groups that are likely to influence implementation: interest group politics, bureaucratic politics, budget politics, leadership politics, beneficiary politics, and external actor politics. The categories of stakeholders can be overlapping. We examine the politics of these different stakeholder categories, and then present selected examples of published case studies that show the types of implementation challenges that arise for each category and how implementers can use political strategies to manage specific stakeholder groups and related political processes. Understanding the political dimensions of implementation can help those responsible for implementation drive policy into practice more effectively. Understanding and addressing conflict, resistance and cooperation among stakeholders are key to managing the implementation process. Systematic and continuous political analysis can help decision makers and change teams improve the chances for successful implementation.

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Section: Leadership Politics ("Managing Up")mentioning

confidence: 99%

“…After months of back-and-forth discussions between the MoH and MoLSS, "the prime minister personally called the Minister of Labor and Social Security to inform him that all SSK hospitals would be moved under the MoH virtually overnight." 30 Beneficiary Politics (Managing Down)…”

Section: Leadership Politics ("Managing Up")mentioning

confidence: 99%

Political Analysis for Health Policy Implementation

Campos

Reich²

2019

Health Systems & Reform

Self Cite

148

110

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“…The backbone of the HTP was to increase the number of family physicians practising in Turkey, with primary care paid for by state insurance and provided in state-contracted Family Medicine Centers 23. This allowed for continuity of care, locally responsive health policy and oversight.…”

Section: Applications Of the Primary Care Spend Modelmentioning

confidence: 99%

“…These assertions are born out through the results of Turkey’s health reform, which includes increased life expectancy, improved maternal and child health and widespread vaccination coverage. Figure 4 categorises the HTP reforms within the context of the PC Spend Model using extrapolation based on service-oriented outcome studies 21–23. This demonstrates the potential utility of depicting change in primary care activities and care delivery using the model.…”

Section: Applications Of the Primary Care Spend Modelmentioning

confidence: 99%

The Primary Care Spend Model: a systems approach to measuring investment in primary care

et al. 2019

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Increased investment in primary care is associated with lower healthcare costs and improved population health. The allocation of scarce resources should be driven by robust models that adequately describe primary care activities and spending within a health system, and allow comparisons within and across health systems. However, disparate definitions result in wide variations in estimates of spending on primary care. We propose a new model that allows for a dynamic assessment of primary care spending (PC Spend) within the context of a system’s total healthcare budget. The model articulates varied definitions of primary care through a tiered structure which includes overall spending on primary care services, spending on services delivered by primary care professionals and spending delivered by providers that can be characterised by the ‘4Cs’ (first contact, continuous, comprehensive and coordinated care). This unifying framework allows a more refined description of services to be included in any estimate of primary care spend and also supports measurement of primary care spending across nations of varying economic development, accommodating data limitations and international health system differences. It provides a goal for best accounting while also offering guidance, comparability and assessments of how primary care expenditures are associated with outcomes. Such a framework facilitates comparison through the creation of standard definitions and terms, and it also has the potential to foster new areas of research that facilitate robust policy analysis at the national and international levels.

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“…Very generally, low levels of insurance coverage, poor service quality, inefficiency, and inequity reigned (Rosetti 2004:19 in Agartan :9; Atun et al :6). A noncontributory program called the Green Card program that served the poor was established in 1993 but was utilized by less than 4% of the population, even though a much higher percentage of the population was eligible, due to bureaucratic inefficiency and corruption (Sparkes, Bump, and Reich ). More broadly, low state spending levels and a limited capacity of the state in collecting contributions—amid a high degree of informality and high levels of out‐of‐pocket spending by citizens—created a number of barriers to access (SPO 1990:170 in Agartan :976; Yilmaz :74).…”

Section: The Politics Of Expanding Healthcare Access In Turkeymentioning

confidence: 99%

The Politics of Expanding Healthcare Access to the Poor and Informal Sectors

Harris

2019

Sociological Forum

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How do the politics of agenda setting and policy adoption operate in the arena of healthcare reform in the industrializing world? Literature on the twenty-first-century developmental state emphasizes the role of democratic competition and civil society in causing political parties to take up new agendas, while power resources theory stresses the role of left-wing political parties and labor unions in policy adoption. Yet, core tenets of these theories have not been considered extensively in light of dynamics in the industrializing world. This article examines the politics of policy adoption in countries that have recently aimed to provide healthcare access and financial protection to the poor and people in the informal sector in Mexico and Turkey. In line with literature on the twenty-first-century developmental state, we find democratic competition to play an important role in causing political parties to take up new agendas. However, examination of the cases illuminates surprising dynamics that challenge important elements of sociological theory: right-leaning political parties played important roles in adoption, while labor unions and left-wing parties oppose reform in the cases. Public health-minded physicians leading change teams played important roles in agenda setting and leading the process of implementation.

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Political Strategies for Health Reform in Turkey: Extending Veto Point Theory

Cited by 22 publications

References 16 publications

Political Analysis for Health Policy Implementation

Political Analysis for Health Policy Implementation

The Primary Care Spend Model: a systems approach to measuring investment in primary care

The Politics of Expanding Healthcare Access to the Poor and Informal Sectors

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