Involvement of Ministries of Health in Health Service Coverage Decisions: Is England an Aberrant Case?

This article examines the involvement of ministries of health in making health service coverage decisions in Denmark, England, France and Germany. The study aims to inform debate in England about the feasibility of reducing perceived ministerial and bureaucratic ‘interference’ in decisions affecting the National Health Service, based on interviews with senior government officials and other health system stakeholders. Ministries of health differ in their involvement in health system governance and coverage decisions (‘the benefits package’), reflecting differences in institutional arrangements. In all four countries, organizations at arm's length or independent from government are either involved in providing technical advice to the ministry of health or have been mandated to take these decisions themselves. However, ministries of health occasionally intervene in the decision‐making process or ignore the advice of these organizations. The Department of Health in England is not an aberrant case, at least in relation to coverage decisions. Indeed, ministries of health in Denmark and France play a larger role in making these decisions. Public pressure, often amplified by the media, is a shared reason for ministerial and ministry involvement in all four countries. This dynamic may thus limit the feasibility of attempts to further separate the NHS from both the Department of Health and wider political pressures.     

Investigation and Analysis of the Current Medical Health Service in Rural Areas

In order to know more about currentmedical health service conditions, the ProjectGroup of Medical Health Security and Fund-raising in Rural China set up by the Develop-ment Research Center under the State Coun-cil organized a large-scale field investigationin 2004. The investigation did not utilize ran-dom samples, but can still reflect to a verygreat extent the actual medical health condi-tions at present in the rural areas.1. Medical health institutions arestill backward in rural areas(…     

The Impact of New Labour Health Policy on Social Services: A New Deal for Service Users' Health?

Summary The health policies of the Labour Government of 1997–2001included an increased emphasis on social services departments'(SSDs) contribution to promoting health. Three dimensions ofthis policy shift are discussed: first, the drive towards organisationalfusion between elements of the NHS and SSDs; second, the newmechanisms for conjoint funding of health and social services;and, finally, the new policy focus on tackling health inequalitiesby combating social inequalities on a national and localitybasis. In each case, the touchstone of our analysis is the consequencesfor the health and well-being of SSD service users as membersof socially disadvantaged groups. We conclude that New Labourhas taken some steps, particularly reducing child poverty, whichwill have long lasting health and social benefits for actualand potential service users. However, inadequate funding ofSSDs undermines their effectiveness as a partner in integratedhealth and social care. As signalled by service user initiatives,SSDs potential for promoting more equal chances of health andwell-being in ill-health will also not be realised without substantialchanges to current SSD policy and practice.     

When is a Health Department not a Health Department? The Case of the US Department of Health and Human Services

Given the current policy debate over health reform in the United States, it is not possible to describe the organizational structure that might emerge from this process. This article explores five of the attributes that underpin the context for a discussion of the structure and operation of a health bureaucracy in the USA. First, ambivalence in the US society about a public commitment to health and a general scepticism about a significant public sector in this area. Second, separation within the system between types of activities (e.g. health research activities, provision of services, and financing of health efforts). Third, the health system operates in the context of a government with shared powers as well as federalism and an assumption that some issues belong to states, and sometimes localities, and not to the federal government. Fourth, difficulty in the US system when it attempts to focus on prevention activities. And fifth, the structure of HHS creates tensions between management initiatives and professional expertise and standards. The article concludes with a discussion of possible organizational alternatives.     

Fraternal foreign policy transfer? Evaluating the case of Australian Labor and British Labour

ABSTRACT

The literature on policy transfer and policy diffusion is vast, but analysis of how this operates in the domain of foreign policy is limited. Is there evidence that policy-related knowledge and ideas in the foreign policy realm are transferred between jurisdictions? This article addresses this question in the context of the relationship between two fraternal social democratic parties – the British Labour Party and the Australian Labor Party. It focuses on the period between 2006 and 2010, which covers Kevin Rudd’s assumption of the Labor leadership and his first term as Prime Minister and the transition from Tony Blair to Gordon Brown in June 2007. Kevin Rudd’s Prime Ministership was terminated in a party room coup in June 2010 while Gordon Brown led the British Labour Party to electoral defeat one month earlier. The article investigates three prominent areas of foreign policy – regional engagement, climate change, and aid and international development – to evaluate the extent of policy transfer and diffusion between the Rudd and Brown Governments. Using the ‘degrees of transfer’ framework outlined by Dolowitz and Marsh, it finds that emulation, policy combinations, and inspiration all featured but that there was scant evidence of complete transfer.     

Developments in the Study of Confucianism on the Mainland of China in Recent Years

I.AttitudesTowardsthe"ConfucianismCraze"AnincreasingnumberofstudiesonConfucianismhavebeenconductedonthemainlandinrecentyears,andthereisevensomethingofa"craze"forConfucianism.Papershavebeenreadatlargesymposia,journalshavebeenpublished,lectureshavebeengiven…     

Why Health Care Reform Now? Strategic Framing and the Passage of Obamacare

Economic reform and health care reform were both focal points outlined in President Obama's policy agenda, with increasing pressure to address economic and social insecurity given that President Obama entered office during the Great Recession (2007–09). The Patient Protection and Affordable Care Act (commonly known as ‘Obamacare’) successfully passed in March 2010 in the context of the economic crisis. We argue that the strategic framing of the economic crisis, through reasoning and arguments linking health care reform with economic downfall, is important in understanding the successful passage of Obamacare, and that this is reflected through strategic frames in speeches delivered by the President on health care reform. Health care reform has been successful not in spite of but rather because of the economic crisis of 2008, that allowed President Obama to use a strategic frame focusing on costs and economic problems. The two main frames identified are the ‘market’ and ‘rights’ frames. President Obama's strategic frames specifically surrounding the economic and cost‐containment priority of health care reform are categorized as a ‘market’ frame in this article. He used this frame until the passage of the law in 2010, when the frame shifted to ‘rights’ frames, largely portrayed through anecdotes and focused on the concept of ‘access’ to care rather than the ‘cost’ of care. This is observable through tracking speeches and statements made in support of health care reform between 2009 and 2013.     

A Comparison of the Narrative Structures of the Three Great Epics of National Minorities in China

Gesar of the Tibetan nationality, Manas of the Kirgiz nationality and Jiangel of the Mongolian nationality are known as the three great epics of the national minorities in China. Gesar has a narrative structure similar to the Ramayana, the great Indian epic with a circular structure of heaven earth heaven; Manas' structure is semi-circular: birth of the hero on the earth performing meritorious deeds death resurrection. Jiangel has a chain structure. In this epic the hero     

Mechanisms of the Effect of Involuntary Retirement on Older Adults’ Self-Rated Health and Mental Health

This study examined mechanisms of the effect of involuntary retirement on self-rated health and mental health among adults aged 50 or older. Using two waves of the Health and Retirement Study (2006 and 2010), we selected a sample of 1,195 individuals working for pay at baseline who responded to a lifestyle questionnaire in both waves. Regression-based path analyses were conducted to test the mediating effects of financial control, positive and negative family relationships, and social integration on the relationship between involuntary retirement and self-rated health and mental health. Results of mediation analyses indicated that transition to involuntary retirement was directly negatively associated with subsequent self-rated health and indirectly negatively associated with mental health via perception of less financial control. Voluntary retirement was indirectly positively associated with both self-rated and mental health via perception of more financial control. No significant direct or indirect effects of retirement were found when retirement was measured with an aggregate measure without specifying its voluntariness. Findings emphasize the importance of specifying the voluntariness of retirement and recognizing the heterogeneity in the mechanisms of involuntary and voluntary retirement.     

Inadequate Policy or Operational Failure? The Potential Crisis of the Korean National Pension Programme

The Korean National Pension Programme is one of the main pillars of the Korean welfare state. From its introduction in 1988, the Programme had come to include 26.8 per cent of the economically active population and had accumulated a pension fund equal to 24 per cent of government expenditure by 1994. Behind such a promising facade, the Korean National Pension Programme is likely to face financial crisis without a major reform. This paper seeks to answer the question as to whether the crisis will arise due to inadequate policy design or to operational failure. The latter cause may require privatizing the Pension Fund in order to operate more efficiently, while the former one would demand rectifying the defects of policy design. This study argues that the crisis is strongly related to inadequate policy design, which promises generous pensions and at the same time requires only a small amount in contributions; although there have also been operational inefficiencies in running the programme. It also argues that inadequacy in policy design stemmed from developmentalism embedded in the Korean welfare state, which regards the National Pension Programme mainly as a measure for mobilizing cheap capital. In conclusion, this paper argues that the Korean welfare state, created in the era of economic development, is transient in nature and that it needs a major reform not only to contain the cost but also to meet the growing demand for social welfare.     

The Influence of Globalization on the Occupational Health of Chinese Women

Under the influence of globalization, economic liberalization and integration have rendered the labor market more flexible and short-term, with more people holding more than one job. Women hold a major part of these informal jobs, which are generally not protected by standard labor legislation. Changes in the nature of employment reduce the application of this legislation. Since the government does not put into effect relevant rules and regulations or enterprises manage to overstep or bypass them, the trade union movement that serves women workers in their call for equality is also weakened. Globalization has led to the mobility of labor. A     

Designing the Financing System of the New-type Cooperative Medi-cal Service in Rural Areas

A total of 310 counties (and county-levelcities) in 30 provinces, autonomous regionsand municipalities directly under the centralgovernment in China had conducted experi-ments of new-type cooperative medical ser-vice in the rural areas by October 2004, cov-ering 95.04 million rural people. The actualnumber of peasants who joined the serviceis 68. 99 million, accounting for 72.6% ofthe total, and 3.021 billion yuan was raised.1. The general principles of financingcooperative medical services in…     

The Administrative Impact of Smallpox in the Early Years of the Qing Dynasty and Measures Adopted by the Qing Court

History is a theatrical stage fraught withhuman activities. The formation of a histori-cal phenomenon not only comes from thepeople’s social activities, but also results fromthe interaction of various factors, includingnatural factors such as plagues. In the earlyQing, a smallpox epidemic had become asevere annoyance to the Qing government.During winter and spring when epidemicsran out of control, the Manchu emperorssuch as Huangtaiji (reigned 1627-1644) andShunzhi (reigned 1644-1662) had t…     

On the Involvement of Social Work in Public Health Emergencies

During discussions on how to respondto public health emergencies some scholarshave made use of Ulrich Beck’s theory ofsocial risks to expose the dilemma and tran-scendence of a risk society. They proposeto do away with discourse centralism andcreate a mechanism of autonomous societythrough consultation, dialogue and commu-nication among different discourses; to doaway with human centralism and seek theharmonious coexistence of man and nature;and to do away with individual and nation-state cen…     

A Summary of Research on the Worksof Modern Chinese Writers in the Last Few Years

Intheearly1990sresearchontheworksofChinesemodernwriters,generallyregardedasthosewriterswhosecareersspantheperiodfromtheMayFourthMovement(1919)tothefoundingofthePRC(1949),inheritedtheacademicideologicaltraditionofthe1980s.Anumberofnewtrendsandchangesalsoemergedinresearchmethodology,researchtargetsandresearchers'selfcorrelation.Thispaperwillsummarizethesedevelopments.ⅠInthelastfewyearsanotablecharacteristicofresearchontheworksofChinesemodernwritershasbeenthediversificationinresearchanglesand…     

Introduction: Reform of the Public Health System Requires That the Public Share Responsibilities

The contributors to this special issue,“Reform of the Public Health Care Systemin China: Challenges and Responses,” comefrom varying organizations — from academicinstitutions to policy research institutes —with varying research backgrounds — fromhealth policy research to social policy re-search and sociology, and to agriculturaleconomics. They have observed the publichealth care system and express their viewsfrom different perspectives: Gong Sen fromthe perspective of health resource a…     

Gender Conflicts and the Limits of Political Democratization in the Early Years of the Republic:As Exemplified by the Proposal for Women Suffrage

Soon after the outbreak of the Revolution of 1911 the Provisional Revolutionary Government was set up at Nanjing. Lin Zongsu, Tang Qunying and other woman revolutionaries submitted in March 1912 a proposal for woman suffrage to the Senate at Nanjing. The Senate turned down the motion, giving rise women petitioners' creating turmoil in the Senate. With the northward movement of the Provisional Senate, the center of the woman suffrage petition movement also shifted to Beijing. They once