Suchergebnisse

Social Policy in East and South East Asia provides the first systematic comparison of the policy sectors of income maintenance, health, housing and education in Hong Kong, South Korea, Singapore and Taiwan. It focuses particularly on the provision and financing arrangements of these four Asian newly industrialized economies and their outcomes in terms of adequacy, efficiency and equity, drawing on extensive primary research carried out by the author.Locating the importance of Asian social policies in the wake of the recent financial crisis in the region, this work provides a comprehensive anal

This book provides the first systematic comparison of the policy sectors of income maintenance, health, housing and education in Hong Kong, South Korea, Singapore and Taiwan.

The government of Hong Kong has been trying to reform the territory's health care financing system since the early 1990s and is finally on the verge of succeeding. The objective of this paper is to assess the reform efforts and explain the causes of repeated failures and eventual success. It will argue that the government's fortunes changed only after it abandoned the core reform goal and decided to pursue peripheral objectives. It will explain the abandonment with reference to the peculiar political system in Hong Kong that makes it difficult for the government to adopt substantial policy reforms in the face of even moderate opposition. The reason for the government's policy incapacity is the existence of liberalism in a non-democratic setting, which allows the government to neither suppress opposition nor mobilize popular support. This has been illustratively evident in its health care reforms when its proposals to improve the system's fiscal sustainability invariably met an early death because they imposed costs on employers, the population or both. The current proposal has fared better not only because it addresses a simpler peripheral problem but also because it offends almost no one and pleases many among the powerful. (Pac Rev/GIGA)

The paper compares healthcare reforms in China, South Korea, Singapore and Thailand with the purpose of drawing useable lessons about the appropriate role of the state in the sector. It argues that healthcare reforms in China and Korea offer many negative lessons for healthcare reformers while Singapore and Thailand offer positive lessons that may be considered for emulation elsewhere. The fundamental lesson to emerge from the successful reform experiences is that a large and active state role in various aspects of healthcare provision and financing is essential for containing expenditures and maintaining access. Public ownership of providers and prospective payments are particularly effective in controlling expenditures while direct government financing promotes equitable access. The cases also show that political economy matters: the Singapore and Thai states' strong presence in the healthcare sector is a vital reason for their superior performance.

The Singapore government began to reform public hospitals in the mid-1980s because of mounting public expenditures on health care. It granted public hospitals managerial autonomy and required them to compete for patients' fees. Correspondingly, patients were required to pay a larger proportion of the costs. When subsequent evidence showed that costs were increasing rather than decreasing, in the mid-1990s the government began to reassert its control while retaining the essence of the earlier reforms. In recent years, the reforms have emphasized management autonomy coupled with strong government guidance. This article assesses the autonomy and control mechanisms in place to promote effective service delivery in public hospitals in Singapore and concludes that reliance on market competition requires more state intervention than often realized. For market competition to deliver outcomes that are not only economically efficient and consumer-friendly but also politically acceptable, constant governmental oversight and coordination is essential.