德国医疗体制面临新变革

有关全民健康的医疗卫生事业涉及到每个国民的切身利益,因而也是各国政府最重要的任务之一.尽管发达国家与发展中国家对此所面临的问题与困难有所不同,但这并不妨碍彼此学习和相互借鉴.     

Public administration and public policy: old perspectives,new directions

Public administration has rather studiously avoided serious consideration of its ties to public policy throughout most of this century. The politics/administration dichotomy leaves a lasting legacy. Policy has a central place in the ongoing effort to explain what public administration is and how it functions. Policy defines the purpose of agencies, stipulates much of the detail about their organization, provides authority and legitimacy, and makes them important -- probably the most important--instruments of policy effectuation and evaluation. Public administration has traditionally displayed an interest in management; it has been studied, taught, and practiced as method, “how to.” This instrumentalist orientation has addressed successively different perspectives, all subsumed within the rubric of public administration. The first of these emphasized administrative reform, followed by an interest in scientific management. These left a legacy that largely treated administration as an end in itself, divorced from matters of policy. Further developments during the depression and post-war years gave prominence to human relations and decisionmaking. These newer orientations emphasized public administration's non-involvement with policy, although decisionmaking proved less inward-oriented and contributed some methodological insights for better understanding policy's ties to public administration. Decisionmaking's preoccupation with unifunctional organizations accountable to a single power center has proved a formidable obstacle to empirical investigations of policy/administration ties, however. This dilemma calls for new perspectives from which to study these ties; one promising perspective is the examination of administrative involvement in successive stages of the policy process.     

Adarand v. pena: turning challenges into opportunities

This article provides a historical and legal overview of preference and set-aside programs. Further, the barriers and driving forces that have influenced preference programs are discussed. Finally, the processes, strategies, programs, and criteria employed at the Metropolitan Washington Airport Authority and Port Authority of New York and New Jersey, to meet the test of strict scrutiny in Adarand, will be explored and analyzed as alternatives for preference programs.     

Extractive peasants: reframing informal artisanal and small-scale mining debates

This paper explores the ongoing reconfiguration of peasant labour processes from agriculture to informal mineral extraction, outlining the motivations of the rural poor in adopting mining and quarrying, and discusses how social sciences can best account for this significant shift towards extractive livelihoods. It argues that the ‘extractive peasants’ best explain the contemporary changes in rural, mineral-rich tracts throughout the Global South, and peasant mining practices are part of the informal economies. The extractive peasants return intellectual attention to practices that disrupt contemporary global mineral production and place the politics of the poor within broader debates on resource politics.     

National development and the globalisation discourse: Confronting 'imperative' and 'convergence' notions

The Bonn Agreement of December 2001 lays the foundations for a political transition in Afghanistan after 23 years of war. The agreement excludes the defeated party, the Taliban, while seeking to commit the remaining groups to a long-term and loosely defined peace process. With Afghan regionally based political-military groups defined largely along ethnic lines, and closely linked to external powers, rebuilding national authority will be a slow and conflictual process. Rebuilding the coercive capacity of the state is essential to overcome strong centrifugal tendencies, yet must be timed so as not to get ahead of the restoration of legitimate political authority. International assistance can support the political recovery by being conscious of the need to neutralise the 'spoilers' of the peace process. Making haste slowly in aiding economic recovery can prevent armed competition for power at the centre. To promote this kind of transition, and promote Afghan influence in the peace-building process, the international aid community must fundamentally reorient the strategies and methods of past involvement in the country.     

Chinese capitalism: Cultures,the Southeast Asian region and economic globalisation

Globalisation is often presumed to be an economically, socially and culturally homogenising force. The deterioration of capitalism's major rival in the early 1990s has paved the way for a truly global economy in which all participants increasingly operate under the general logic of capitalism-that is, a market-orientated system of production and exchange, private ownership and a flexible labour market predicated upon self-interest. Yet, while the pressures of globalisation are obviously formidable and increasingly felt by all, economic societies remain diverse and have responded to these pressures in unique ways. This article makes its case for the continued diversity of capitalism by emphasising the unique mode of economic organisation that has emerged in Southeast Asia; one rooted in the demands of globalisation as well as in the cultural foundations of the Overseas Chinese. The evolution of ethnic-Chinese business networks, which define Southeast Asia's political economy, constitutes a unique reaction to the pressures of globalisation and has laid the basis for a distinct articulation of capitalism in the region.     

Varieties and crises of neoliberal globalisation: Argentina,Turkey and the imf

Argentina and Turkey are two important ‘emerging market countries’ that experienced a major economic crisis during the same year. Focusing on the period leading up to the respective 2001 crises in the two countries, this article attempts to place the two experiments in historical perspective and provide an understanding of the common elements as well as the diversity of the neoliberal restructuring process in semi-peripheral settings. The article also attempts to identify some of the key mistakes made by the imf, which was, in part, responsible for the crises experienced. A central conclusion is that ‘new’ or unconsolidated democracies find themselves particularly vulnerable when they are suddenly and prematurely exposed to financial and capital account liberalisation. The outcome is a highly fragile, debt-led growth path with costly consequences. Indeed, although both countries have managed to accomplish impressive recoveries in the post-crisis period, given their past trajectories and the heavy debt burden that they face, it is too early to say that the recovery process will be translated into sustained and crisis-free growth. The regional environment in which the two countries find themselves might be particularly important in this context, with the powerful EU anchor a possible important advantage in the Turkish context.     

The identity crisis in Jordan: historical pathways and contemporary debates

This study aims to identify the attempts to form a Jordanian national identity from the establishment of the Jordanian state in 1921 to date. This study reviews the efforts of the Jordanian state, which was subject to internal, external, political, social, economic, and cultural circumstances, and variables that led to change the Jordanian national identity to incorporate religious, national, regional, ethnic, and tribal aspects. The regime has been unable to address and resolve the issue of national identity; instead, it has tried several means to circumvent the problem of national identity. The identity card is a means that the regime has used to achieve its goals. These policies led to the state’s failure to define, establish, and maintain a comprehensive national identity for its citizens. The formation of a national identity has been a dilemma for Jordan since the establishment of the state; there is almost no known national identity. This situation calls for the construction of the Jordanian national identity on a fixed and clear basis to prevent its disintegration, to facilitate the process of social integration, and to build a final national identity that is both inclusive and representative. Without this identity, division and conflict may prevail in Jordanian society.     

Putting power into practice: Administrative and political capacity building in the European Parliament's Committee for International Trade

As the formal powers of the European Parliament have increased with successive treaty changes, its committees' administrations have seen a parallel growth. We argue that such administrative capacity is necessary but not sufficient for acting on formal treaty powers. Administrative capacity has to be combined with political capacity in order to muster policy impact in European Union decision‐making. By differentiating between intra‐institutional administrative and inter‐institutional political capacity, we offer a fine‐grained conceptualization of policy capacity while broadening the theoretical and empirical understanding of the European Parliament's administration as an organizational structure of formal and informal working practices, intra‐institutional coordination and inter‐institutional relations. Based on expert interviews, document analysis and participant observation, the case of the Transatlantic Trade and Investment Partnership illustrates how societal politicization of a specific policy issue triggered the European Parliament to exploit the latent potential of its post‐Lisbon administrative capacity by transforming it into a more readily deployable political capacity.     

Self-rated health and barriers to healthcare in Ukraine: The pivotal role of gender and its intersections

The ongoing health crisis in the Ukraine has persisted for 48 years with a clear division of gender-based outcomes as seen in the decline of male life expectancy and stagnation of female longevity. The purpose of this paper is to investigate differences in self-rated health and system barriers to health care applicable to gender and its intersections because of the differing negative health outcomes for men and women. Intersectionality theory provides an analytic framework for interpreting our results. Utilizing a nationwide sample of the Ukrainian population (N = 1908), we found that low socioeconomic status (SES) women rate their health worse than men generally and any other socioeconomic group. Yet women also face the greatest barriers to health care until older ages when the ailments of men cause them to likewise face the obstacles. In reviewing the barrier to health care scale, one barrier—that of health care services being too expensive—dominated the responses with some 52.5 percent of the sample reporting it. Consequently, the greatest problem in Ukraine with respect to health reform reported by the population is the out-of-pocket costs for care in a system that is officially free. These costs, constituting some 40 percent of all national health expenditures, affect women and the aged the most.     

The capitalist conjuncture: over-accumulation,financial crises,and the retreat from globalisation

This article argues that the key crisis that has overtaken today's global economy is the classical capitalist crisis of over-accumulation. Reaganism and structural adjustment were efforts to overcome this crisis in the 1980s, with little success, followed by globalisation in the 1990s. The Clinton administration embraced globalisation as the ‘Grand Strategy’ of the USA, its two key prongs being the accelerated integration of markets and production by transnational corporations and the creation of a multilateral system of global governance, the pillars of which were the World Trade Organization, the International Monetary Fund and the World Bank. The goal of creating a functionally integrated global economy, however, stalled, and the multilateral system began to unravel, thanks among other things to the multiple crises created by the globalisation of finance, which was the main trend of the period. In response partly to these crises, partly to increasing competition with traditionally subservient centre economies, and partly to political resistance in the South, Washington under the Bush administration has retreated from the globalist project, adopting a nationalist strategy consisting of disciplining the South through unilateralist military adventures, reverting to methods of primitive accumulation in exploiting the developing world, and making other centre economies bear the brunt of global adjustments necessitated by the crisis of over-accumulation.     

New federalism and health policy

The making of health policy in the United States is a complex process that involves the private and public sectors, including multiple levels of government. Five characteristics of the policy process are identified, which establish the means by which policies are formulated and which affect the nature of the policies that emerge. These characteristics include (1) the relationship of the government to the private sector; (2) the distribution of authority and responsibility within a federal system of government; (3) the relationship between policy formation and implementation; (4) a pluralistic ideology as the basis of politics; and (5) incrementalism as the strategy for reform. The article focuses on the impact on health policy of the distribution of authority and responsibility within the federal system, particularly the impact of new federalism policies as they emerged during the past decade. The effects of dual federalism, cooperative federalism, creative federalism, and new federalism are examined in relation to health policies. The article concludes with an examination of the challenge to long-established values and health policies posed by new federalism.     

Managing the difficult past: Ukrainian collective memory and public debates on history

This article analyzes the status of difficult historic events in Ukrainian collective memory. Difficult elements of collective memory are defined as those which divide society on basic matters, such as identity and national cohesion, and events which are being actively forgotten because of the role of Ukrainians as perpetrators. Three such issues were analyzed: World War II and the role of the Ukrainian Insurgent Army (UPA), the Holocaust, and the ethnic purge of Poles in Volhynia and Eastern Galicia in 1943–1945. Utilizing data from quantitative and qualitative studies, the author showcases the significance of these issues for contemporary Ukrainian identity and Ukraine’s relations with its neighbors. In particular, the evaluation of World War II and the role of the UPA in Ukrainian history polarizes Ukrainian society to a great degree. At the same time, this element of national history is used to construct a common, anti-Russian identity. The difficulty of relating to the memory of the Holocaust and the ethnic purge in Volhynia is of a different character. These events are problematic for Ukrainian collective memory because they demand a painful settling of accounts with the past. At present, only Ukrainian elites are willing to work on these subjects, and only to a limited degree, while the common consciousness either denies or ignores them altogether.     

Neoliberal globalisation,the nation-state and financial crises in the semi-periphery: A comparative analysis

The process of neoliberal globalisation has been associated with successive financial crises in the context of the 1990s, raising serious doubts concerning the sustainability of rapid growth in an environment of uncontrolled movements of short-term capital. The article probes into the origins of the financial crises in the semi-periphery through a structured comparison of three key recent crises in the world economy, namely the Mexican and Turkish crises of 1994 and the Asian crises of 1997. Whilst the magnitude of the capital flows and the dimensions of the subsequent crises are strikingly different, there are nonetheless important elements common to all three cases studied. One such common element involves the overdependence of the countries concerned on the short-term financial flows, in a setting characterised by premature capital account liberalisation in the absence of adequate regulation. It is striking that, contrary to the conventional IMF wisdom, financial crises have occurred in spite of 'sound fundamental', namely fiscal equilibrium and low inflation. The recent financial crises highlights a paradoxical situation: the need for effective regulation at a time when the capacity of the nation state to undertake the type of regulation needed severely circumscribed. Hence, the establishment of an effective regulatory framework at the global level emerges as a major requirement if successive financial crises, with significant economic and social cost, are to be avoided in the future.     

Post-Arab Spring: changes and challenges

This paper advances the proposition that post-Arab Spring politics are a product of globalisation’s economic and social liberalisation. The global market and privatisation have fundamentally deconstructed centralised autocratic rule over state and society, while facilitating corruption and selective development, culminating in public outrage. The political order of the Middle East and North Africa since the Arab Spring synthesises globalisation’s dialectic duality, in which economic integration has contributed to the demise of national authoritarianism, inciting communalism and political fragmentation. This paper analyses emerging political trends and challenges based on a comparative analysis of Egypt and Tunisia.