The New Left and Health Care Reform in El Salvador

After a decade of civil war and four consecutive conservative administrations, El Salvador's leftist FMLN won its first presidential election in 2009. How has public policy changed under this New Left government, and why? This article addresses the question in the area of public health care. An alliance of health sector leaders with both technocratic and diplomatic abilities capitalized on the policy window opened by the FMLN's electoral victory and worked within the parameters set by President Mauricio Funes, the FMLN, and civil society to universalize health care. The new minister of health, a professional highly esteemed inside and outside the country, was able to engage both a large social movement protesting neoliberal policy and an energetic health diplomat sent by the Pan American Health Organization. In designing its reform, this alliance benefited from international as well as “bottom‐up” policy diffusion.     

Explaining Policy Stability and Change in Swiss Health Care Reforms

The article investigates recent health reforms and reform attempts in Switzerland. A substantial reform, the revision of the health insurance law in 1994, is followed by a long period of refused reform proposals and incremental change. In order to explain policy change and policy stability in health policies, we apply veto‐player theory to partisan and parliamentary debates on reform proposals of the health insurance from the end of the 1980s until today. Shifts in ideological positions of parties, especially with regard to the objective of solidarity, allowed for a new win‐set in the 1990s that was at the base of the law revision. Since then, the win‐set is empty as parties did not change their preferences. New and substantial reforms will only be possible, it is concluded, if the pivot player, the Christian‐democratic party, changes its ideological positions to a significant extent.     

Japanese imperialism and Mongolian Buddhism, 1932-1945

Between 1932 and 1945 imperial Japan had strong political and strategic interests in the Mongol lands. To win Mongol backing for the Japanese war effort and to strengthen the Mongol regions as a base for Japanese operations elsewhere on the Asian mainland, the Japanese military authorities developed a complex policy to support and reform Mongolian Buddhism. In pursuit of their goals, they promoted changes in Buddhist religious practices and fostered the use of monasteries as conduits for modern education and health care. Mongolian Buddhists themselves took part in these reforms but they generally accepted only those changes that were already a part of Mongol political and religious thinking.     

谁在反对公共养老金改革:利益还是制度?——评《阶级分化与代际分裂:欧洲福利国家养老金政治的比较分析》

This essay is a short comment on the newly published book by Dr. Liu Ji,Class versus Generation Cleavages:A Comparative Analysis of the Politics of Pension Reform in European Welfare States,one of the monographs thoroughly exploring the welfare crisis in west European countries since the 1990s. The author focuses on the roles of the various social coalitions with veto powers during the retrenchment process of public pensions in 5 European countries. He finds out the causal relationship between the intensity...     

The Inextricable Link Between Sovereign Debt and Pensions in Argentina, 1993–2010

Established with the reform of 1993, Argentina's private pension funds became crucial sources of credit for the national government. They purchased large amounts of sovereign bonds defaulted on in 2001 and hence were key to the success of the debt restructuring of 2005. The private pillar was always vulnerable to political maneuvering; the nationalization of private pension funds in 2008 was only the last stage in an iterated process of state intervention, a function of public debt dynamics. This article argues that the financial pressures associated with Argentina's sovereign debt burden systematically shortened the temporality of pension policy decisions, taking those away from long‐term concerns about the stability of the social security system and toward the immediacy of debt‐financing imperatives. Therefore, the politics of pension reform reversal in Argentina were determined by the increasingly strong and inextricable link between debt and pensions.     

奥巴马政府的医疗改革及其前景

奥巴马总统上台后启动的医疗改革是一场规模空前、任务艰巨、争论激烈、过程曲折的重大社会改革,其主要目标是抑制急速膨胀的医疗保健费用及其导致的巨额财政赤字,扩大医疗保险覆盖面,提高医疗服务质量,让医疗保健体系适应21世纪美国加强国家竞争力的要求。迄今为止,改革取得的主要成果是美国国会参众两院通过的医疗改革议案及其修正案,距离最后的成功仅一步之遥。尽管改革过程和方案存在重大缺陷,改革的前景也充满变数和挑战,但奥巴马政府已经创造了历史,初步实现了美国医疗改革的百年梦想,奥巴马也将由此形成他最重要的政治遗产。     

The 1992 health reform victory over pressure group politics

The 1988 health reform was substantially undermined by the influence of powerful pressure groups representing the interests of the medical profession and the pharmaceutical industry and resistance from the German federal states. Consequently, it failed to achieve its aim of ‘cutting costs’. The theory supporting ‘resistance to reform within the health care system’ was widely accepted in the literature on the subject. The 1992 reform appeared to contradict this theory, as the political leadership succeeded in overcoming both party policy and intergovernmental differences, as well as making considerable cost savings and structural changes in spite of resistance from the opposition ‘lobby’. Three factors were responsible for this. They were under enormous pressure to act due to the financial crisis and the interdependent costs within the welfare state, the changing motives within the health care system, and a new political strategy which responded to this. In the long term, prospects are for a trend towards ‘greater privatisation’.     

Promises and Pitfalls of Veto Player Analysis

Veto player approaches have come to occupy a central role in comparative politics. This article critically reviews the literature, focussing especially on veto player explanations of policy outputs and outcomes. The review highlights three problems empirical veto player studies have to face: 1) identifying the relevant veto players, 2) establishing equivalence between veto players, and 3) specifying (theoretically or empirically) veto players' policy preferences. The article concludes that empirical veto player analyses advance our understanding of political institutions and their effects, but that they should deal more systematically with the three above mentioned problems.     

Fighting with Goliath: The reform of the public health care insurance scheme in Germany,its potential to increase employment and alternative models of reform

Faced with steadily growing expenditures of the public health care insurance companies, rising statutory contributions for health care insurance and constantly high unemployment, the German government decided to introduce a reform of the public health care insurance scheme that came into force in January 2004. The first part of this paper discusses the reasons for the reform and presents its central elements. Since the reform was introduced to contribute to an increase of legal employment by a reduction of statutory contributions to the public health care scheme, I will discuss the reform's potential to increase employment. In the next step the paper illustrates alternative models of health care reform (citizen's scheme and individual health care premium) and compares their potential for job growth. Although the health care reform of the government considers both the need to reduce statutory contributions to public health care insurance and to ease income tax in order to compensate for higher individual payments for medical treatment, its potential for job growth is limited because it lacks support from the health care bureaucracy and the pharmaceutical industry. A reform of welfare state politics resembles a fight with a Goliath made up of powerful interest groups, a reluctant bureaucracy and uncertain socio-economic outcomes.     

The Exoteric Politics of Bank Mergers in Australia

The Australian government's 1997 policy ban on in-market mergers among the largest four domestic banks has been a key intervention shaping the direction of bank consolidation in Australia as such mergers significantly accelerated from 1997 through 1999 in developed economies. This paper will show that the knowledge about the social and economic impacts of the bank mergers and the Treasurer's merger veto power made the policy debate exoteric (political and public) by including interests outside the banking policy community (i.e., interest organisations of employees, customers, and farmers, as well as political parties, and the broad public). Thus, the merger policy discussions were not esoteric, technical and limited to a small number of influential public and private sector institutions leaving policy discussions vulnerable to be structured to favour the interests of large, financial firms over other interests. This, in turn, created significant pressure on government for to retain the policy. The paper also outlines the significance of the domestic political conflicts and electoral politics in a world of global finance.     

Health Policy in Chile: The Return of the Public Sector?

Health policy in Chile has mirrored the main changes in economic policy in recent times. The 1950s and 1960s witnessed centralisation of public health care into a National Health Service. Neoliberal policies in the 1970s and 1980s refocused health policy onto extending the scope for private insurance and provision in health care. The return to democracy in 1990 has produced a reappraisal of health policy, with the emphasis on strengthening and improving public health insurance and care. This paper examines the extent to which recent changes in health policy signal a reappraisal of the private-public mix in the provision of basic services, and argues that a model for health care and financing built around a strong, modern, and efficient, public health care sector is more likely to succeed in addressing the health needs of the population in Chile and Latin America.     

缅甸外交政策的新调整:从对华友好到大国平衡外交

1988年政变上台的缅甸新军人政权,遭到西方国家的制裁,不得不努力发展与中国的关系,以稳定国内局势。在统治得到巩固后,缅甸新军人政权开始奉行大国平衡的外交政策,即在继续发展对华关系的同时,努力改善与东盟、印度和日本的关系。本文还分析了缅甸奉行大国平衡外交政策的原因:内因是缅甸国内的民族主义情绪不断上升,外因是区域内外各有关国家对中国在缅甸及周边地区影响不断扩大存在恐惧心理。     

The Bologna Process in German Educational Federalism: State Strategies,Policy Fragmentation and Interest Mediation

The article provides an impact assessment of the current European higher education reform (Bologna process) in the context of German educational federalism. The goal is to come to grips with the puzzling observation that the reforms have had a large impact, even though the joint decision-making trap of German educational federalism has continuously impeded structural changes in previous decades. It suggests that the reason why the Bologna process has been so influential is its openness, ambiguity, and the complete absence of binding commitments. These characteristics of soft governance dovetail with the strategy of the central government and the federal states to protect their political autonomy against potential threats resulting from inter- and transnational political cooperation as well as the national reform of the constitutional principles of federalism at home. However, drawing on empirical examples of policy fragmentation, understood as the co-existence of partly incompatible reform islands, illustrates the costs of soft governance in the national implementation process.     

The Ambiguity of Veto Power in Coalitions: German Liberals' Role as a Watchdog in Justice and Home Affairs and their Failure to Sell Stalemate as Success in the Federal Elections of 2013

The article demonstrates that the rigid use of veto capacity in coalitions causes risks for re-election. Justice was a high-salience domain of the German Liberal Democratic Party (FDP), which occupied this portfolio in its coalition with the Conservative majority in the federal legislative period from 2009 to 2013. By analysing several legislative projects the article shows that their contents or non-adoption were an effect of liberals' vetoes. This policy-seeking strategy provoked conflicts within the coalition and stalemate making it impossible to realise popular measures that would have enhanced the Liberals' reputation and the importance of the domain for the voters who were mainly interested in economic and social policy. Moreover, the Liberals' vetoes led to a loss of support from its major coalition partner in the pre-election campaign. Thus governmental parties have to trade off policy and vote-seeking goals in order to get re-elected.     

The Elusive Goal in Democratic Chile: Reforming the Pinochet Labor Legislation

Despite major attempts by the three governments of the post-Pinochet era, the promised reform of the labor legislation inherited from the military regime remains essentially incomplete. This study attempts to explain why, and addresses some of the consequences of this delay for Chilean organized labor, examining particularly the variables of consensus politics and employer concessions.     

日本的社会教育研究

明治维新后,日本的社会教育研究历经二战前后的奠基阶段和重振阶段,呈现出不断发展的过程。本文分别从社会教育的概念、特征、意义、内容、政策法规、公民馆、社会教育史等方面来概览社会教育的研究主题。在此基础上,对未来日本社会教育的研究趋势进行展望,即立足终身学习开展社会教育研究、社会教育研究内容逐步突出功能性、社会教育的形式关注民间力量、社会教育政策研究注重与教育改革同步、社会教育研究范畴趋向独立等5方面。     

“战争罪犯”还是“民族英雄”——以日本战后恢复对军人和战犯的抚恤政策为视角

对军人军属进行抚恤是日本军国主义战争动员的重要内容,日本战败后曾经一度废除。《旧金山和约》签订后,日本政府很快恢复了对不包括战犯在内的复员军人的抚恤、救助工作。在日本遗族会等保守团体的推动和"战犯释放运动"的影响下,经过几次修改,至20世纪50年代中期,日本政府全面恢复了对包括战犯在内的军人军属抚恤工作。无论是刑死还是狱死的"战犯"均被视为因公死亡享受抚恤,战犯服刑期间仍被作为"在职期间"累积计算抚恤年金,服刑期间伤病者另可以享受"伤病抚恤",战争罪犯俨然成了日本的"民族英雄"享受优待。日本政府从立法层面恢复对战犯的抚恤,对日本社会的战争认识和战争记忆的重构产生深刻的影响,也成为此后甲级战犯被靖国神社合祀的社会意识的基础。     

The world bank,health policy reforms and the poor

Over the years, since the mid-1990s, World Bank-prescribed health policy reforms have successfully introduced market-based private-managed healthcare model in the developing world. This article presents a portrait of the private healthcare model, explores the factors that facilitated the introduction of this model in developing countries and examines the impact of the model on the health rights and health conditions of the poor. It argues that health reforms designed to promote private-managed care in developing countries affect the poor severely and violate their basic health rights, the rights to stay disease-free and lead a healthy life. A host of factors produced by the private-managed care model, most notably reduced social spending on public health, dismantling of public health systems and the ever expansionary grip of private sector health services have effectively diminished the health rights of the poor.     

Policy Transfer and Discursive De-Europeanisation: Higher Education from Bologna to Turkey

Abstract

This article analyses Turkey’s integration into the Bologna Process, concentrating on the questions of why and how Turkey is transferring norms in the area of higher education. As an example of policy transfer, the Bologna Process provides important insights into the question of why states choose to voluntarily adopt norms where there is no top-down pressure for change. Focusing on Turkey as a case study, the article identifies the narratives of the agents of change responsible for the reform process. The agents are the intermediaries in the Europeanisation process – they construct the discourses and they are the ones responsible for transmitting the process to the society at large. The article concludes that while institutional Europeanisation is taking place in the area of higher education, discursive Europeanisation is lacking.     

(Un?)Healthy Politics: The Political Determinants of Subnational Health Systems in Brazil

How does political competition shape institutions that govern the expansion of social policy subnationally? Brazilian states have shown a surprising variation in the design of their public health institutions, which regulate the distribution of health resources and citizen access to public health care. While many states have experienced fragmentation, some have remained highly centralized and discretionary, and only a select few have established a coordinated system based on power sharing and rules‐based distribution. Accounts that link public health care expansion to federal government imposition, the presence of the public health care movement, and leftist parties cannot fully explain this variation. Instead, in the three Brazilian states examined here, the nature of subnational political competition triggered different institution‐building strategies. The findings indicate that plural political competition yielded incentives for limiting state‐level discretion and for sharing power with municipal governments, while political concentration reinforced the attraction to centralized and discretionary policymaking.