Nondecision making and inertia in Portuguese health policy

Despite there having been a positive context for initiating health care reforms in Portugal in the past fifteen years (accompanied by political consensus on the nature of the structural problems within the health care system), there has been a lack of reform initiatives. We use a process-based framework to show how institutional arrangements have influenced Portuguese health care reform. Evidence is presented to demonstrate inertia and nondecision making in three critical areas of Portuguese health policy: clarifying the public-private mix in coverage and provision, creating financial incentives and motivation for human resources, and introducing changes in the pharmaceutical market. Several factors seem to explain these processes, namely, problems in the balance of power within the political system, which have contributed to a lack of proper policy discussion; a lack of pluralism in the formation of health care policies (with low participation from citizens and high mobilization among structural interest groups); and the low priority of health care in public sector reforms. Portuguese politicians should be aware of the pitfalls of the current political system that constrain participatory arrangements and pluralism in policy making. In order to pursue health care reform, future governments will need to counterbalance the strong influence of structural interest groups.     

The implementation of quality and safety measures: from rhetoric to reality

The evolution of American healthcare is the history of recurrent attempts to enhance quality of care. The latest wave of debate in this area was sparked by the 1999 Institute of Medicine Report, To Err is Human. In the current debate over how best to improve safety and quality, however, there has been a disconnect between the theoretical optimum and the practical possibilities. The author examines the history of our nation's efforts at healthcare improvement over the years, and concludes that the present debate will likely lead to improvements--but only after a messy (and necessary) political struggle over what price Americans are willing to pay for improvement, and where that money will come from. When reform occurs, the author believes that it will be on multiple levels, with accreditation organizations and various levels of government acting in the manner (and for the constituencies) appropriate to each. Ultimately, the political processes will yield a variety of approaches to be watched, studied, and amended as the healthcare system evolves to provide safer, more effective care.     

Corruption and reform in China: An analysis of unintended consequences

Although market-driven reforms are bringing hope for China's economic development, there has been an increasing visibility of corruption in the reform process. This article examines the relationship between corruption and reform in China by relating the corruption issue to certain reform policies. It finds that corruption results from unintended consequences of some intended reform policies, as these policies aimed at transforming China's socioeconomic structures at the same time inadvertently produce some political and economic conditions conducive to corruption. The unintended consequences are controllable, however, if a balanced reform agenda is developed.     

The Portuguese Parliament and Public Opinion: A Case for Reform?

During the past decade, the Portuguese political system has been under close scrutiny. As in other Western democracies, the topic of citizens' dissatisfaction with democratic institutions has been at the centre of a wide debate amongst public opinion and politicians. This debate has focused on parliament and parliamentary reform has often been seen as a way of enhancing parliament's image. However, as this note will show, there is no clear evidence that the Portuguese are dissatisfied with this institution. Indeed, this is still an under-researched area. Why is there an assumption that the Portuguese parliament has a negative image? And why should this have consequences for parliamentary reform? In the context of the creation of a Portuguese Election Study, this note aims to raise questions for future research on this topic. The note will look into the concept of legislative support, assess the evidence available on the Portuguese parliament's popularity and suggest indicators that would help to clarify the Portuguese views on this. It will also explore the connection between legislative support and the role of parliament, to enquire whether popularity indicators can make a case for parliamentary reform.     

Evaluating Police Reform in Post‐Conflict Nations: A Solomon Islands Case Study

The process of post‐conflict police reform has been the subject of serious scholarly attention, principally driven by the sense that police institutional rebuilding cannot be achieved quickly and that the police are only one part of the wider justice sector. However, police reform is a complicated process, and the cultural, institutional, and political challenges to effective development are immense. The process of reform is further complicated through the inherent difficulty in evaluating the impact of a development programme on police performance. This study uses an outcomes‐ or evidence‐based police measurement system called ‘Police Reform Indicators and Measurement Evaluation’ (PRIME) to assess the performance of the police capacity‐building programme and other improvement projects that have commenced since the deployment of the Regional Assistance Mission to Solomon Islands (RAMSI) in July 2003. The application of the process to the Royal Solomon Islands Police (RSIP) identified that, although there are a number of areas that are still to be strengthened or rebuilt, the Participating Police Force (PPF) has been able to implement capacity development programmes that have resulted in the advancement of the RSIP towards a professional police service. The application of PRIME to the RSIP and the intervening police mission demonstrates that it could be used as a tool to evaluate police reform efforts in similar post‐conflict nations such as Iraq and Afghanistan.     

邓小平“不争论”思想意义解读

邓小平“不争论”思想在1992年形成。它有着特定的政治化背景和特定的内涵。它完善和坚持了党的基本路线，是人民群众思想彻底解放的强大理论武器，也是我们正确理解三个代表重要论述的一把钥匙。它不仅推动了我国改革开放事业的全面深入发展，同时也逐渐改造了我国的政治化。     

The Democratic Costs of Constitutionalisation: The European Case

There is little doubt that the European Union suffers from a legitimacy deficit. However, the causes of this deficit and, as a consequence, the remedies are contested. This article wants to show that an important, but often overlooked, cause for the legitimacy deficit lies in the overconstitutionalization of the EU. The European Treaties have been constitutionalized by the ECJ, but are full of provisions that would be ordinary law in states. Constitutionalization means de‐politicization. What has been regulated on the constitutional level is no longer open for political decision‐making. Thus, in the EU political decisions of high salience are not only withdrawn from the democratically legitimized institutions, but also immunized against political correction. Therefore, the consequences from the constitutionalization have to be drawn: The Treaties should be reduced to those norms that reflect the functions of a constitution, whereas all the other parts have to be downgraded to the level of secondary law.     

The Social Movement Turn in Law

The rise of social movements in US legal scholarship is a current response to an age‐old problem in progressive legal thought: harnessing law for social change while maintaining a distinction between law and politics. This problem erupted in controversy around the civil rights–era concept of legal liberalism defined by activist courts and lawyers pursuing political reform through law. Contemporary legal scholars have responded by building on social science to develop a new concept—movement liberalism—that assigns leadership of transformative change to social movements to preserve conventional roles for courts and lawyers. Movement liberalism aims to achieve the lost promise of progressive reform, while avoiding critiques of legal activism that have divided scholars for a half‐century. Yet rather than resolving the law‐politics problem, movement liberalism reproduces long‐standing debates, carrying forward critical visions of law that it seeks to transcend.     

An agenda for post-troubles policing in Northern Ireland — The South African precedent

Conclusion These proposals represent part of a much larger agenda for policing reform. Critically, it is now time in Northern Ireland, as it was in South Africa, for all sides to start “thinking the unthinkable” if the peace process is to gain momentum. In that process of creating an agenda, opinions will be sought from many quarters. South Africa, in certain limited ways, provides a model of how irreconcilable views about the nature of policing a divided society, can be given serious considerations, of a more peaceful society is to be created. But there is one other crucial lesson from South Africa. Police reform cannot be imposed from above, or according to the dictates of outside experts. It must be based on serious, continuing consultation between all parties — local communities, political parties, the central state, and the police service itself. The South African example demonstrates that existing hostile interests do not have to learn to love one another in making progress in police reform. There is a common interest which surmounts political opposition — local people need the security which an effective, non-partisan police service can provide. minuscule levels.     

A road map for universal coverage: finding a pass through the financial mountains

Government already pays for more than half of U.S. health care costs, and nearly all universal health insurance proposals assume continued government involvement through tax subsidies and other means. The question of what specific taxes could be used to finance universal coverage is, however, seldom carefully examined, in part due to efforts by health care reform proponents to downplay tax issues. In this article we undertake such an examination. We argue that the challenges of relying on taxes for universal coverage are even greater than is generally appreciated, but that they can nevertheless be met. A proposal to fund a universal health insurance voucher system with a value-added tax illustrates issues that would arise for tax-financed plans in general and provides a broad framework for a bipartisan approach to universal coverage. We discuss significant problems that such an approach would face and suggest solutions. We outline a long-term political and legislative strategy for enacting universal coverage that draws upon precedents set by comparable legislative initiatives, including tax reform and Medicare. The results are an improved understanding of the relationship between systemic health care finance reform and taxation and a politically realistic plan for universal coverage that employs undisguised taxes.     

清末民国检察文书的转型与司法现代化——基于司法档案的考察

清末以降的检察制度整体而言处在不断变革和进步之中,其文书的变化尤为明显,作为官方记录反映出司法现代化的进程。在检察制度建立之初,中国传统司法审判中最重要文书之一的批词被适用为主要的检察文书以为过渡,相应的起诉文书也初现雏形;南京国民政府时期,批词转变为近代化的规范文本,起诉书、上诉书现代化成型,其格式、内容也不断适应中央层面的现代化的改革需求,在短短二三十年间经历了从传统到现代的转型。然而形式上的检察文书快速转型与实际检察运作不一致的现象也凸显出近代中国在司法现代化过程中的根本性矛盾。     

论我国法院判定专利权效力的界限——专利无效判断方式的原则与例外

学界对于专利侵权纠纷与确权纠纷解决“双轨制构造”批评颇多,有关问题的解决思路也争议良多、尚难以达成统一意见。专利法需要改革,但改革离不开理论支撑,不可违背基本法理“自说自话”。学者们尚未足够重视专利权有效性推定对于专利无效判断方式所带来的影响。明晰“双轨制构造”背后存在的法理基础,为专利法改革提供基础理论支持,显得尤为重要。在现有的法理基础上进行专利法改革,法院原则上应充分尊重专利局的确权职能,只有在例外的情况下,也即当然无效的情形下才能直接判定专利权效力。     

Is health care different? Popular support of federal health and social policies

Over the past several years there has been a striking increase in policy-makers' attention to health care reform. This paper explores whether there has been a corresponding shift in popular attitudes and identifies factors that may have changed these attitudes. The first part of the analysis relies on survey data collected between 1975 and 1989 to estimate a set of regression models, relating support for federal involvement in health care, antipoverty programs, and general domestic policies to a set of sociodemographic characteristics.... The second part of this study explores motivations that might account for these patterns. We identify a half dozen ways in which health care may be viewed as "different," that is, more or less appropriate for federal action. Analysis of survey data from 1987 suggests that there are relatively small differences in the attitudes and perceptions that motivate support for federal health initiatives, relative to federal domestic policies in general. However, there are more striking differences between health programs and more overtly redistributive policies.... We suggest that the growing support for federal intervention in health care, relative to other social policies, is in part an inadvertent by-product of ideological positions popularized during the Reagan and Bush administrations. We draw from these results some predictions about the course of the ongoing debate over federal health policies.     

Reforming the United Kingdom Constitution: Law,Convention, Soft Law

The Governance of Britain Green Paper continues the programme of constitutional reform begun in 1997, and appears to reinforce the juridification of the UK's constitution. Nevertheless, several key reforms will be implemented not by legislation, but by creating new conventions. This article argues that such ‘declared’ conventions are best understood as a form of constitutional ‘soft law’, which attempt to influence constitutional behaviour rather than generating binding norms. Applying a regulatory analysis, it then argues that the case for a soft, rather than hard law approach to constitutional reform is weaker than its widespread use in the UK suggests. Finally, the article challenges the thesis that the political constitution is being replaced by a legal constitution, arguing that the government's attitude to constitutional reform still exhibits basic characteristics of political constitutionalism. Moreover, there is more to contemporary constitutional developments than a bipolar contest between political and legal constitutionalism.     

It All Went Splendidly for the President

The Constitutional Court of Ukraine (CCU) announced on Friday that it has declared unconstitutional the 2004 constitutional reform, and brought back to life the 1996 version of the Fundamental Law. Now the Verkhovna Rada will have to bring all of the laws passed over the past five years into conformity with the "old" constitution. The CCU decision has given rise to quite a few questions, in particular, regarding the terms of office of the parliament and president. Speaker Vladimir Litvin is sure that the deputies will have to adopt changes to the transitional provisions of the constitution that will extend the authority of the current Rada for a year and a half, and of the head of state for eight months.     

Democratization and political corruption in the Philippines and South Korea: A comparative analysis

The Philippines and South Korea have long had difficult corruption problems. More recently, both have experienced significant democratization. This article compares the two cases, first developing an analysis of corruption in each country, then laying out their reform strategies and assessing their effectiveness, and finally exploring the contrasting relationships between democratization and corruption that are found in these countries. The Philippines confront reformers with more difficult challenges, beginning with the size and decentralization of the society, but other contrasts are important as well. The political will required to produce successful reform has been lacking in the Philippines, for a variety of reasons, while recent anti-corruption initiatives in Korea have had stronger backing. Recent Korean reforms also emulate the successful approaches of Singapore and Hong Kong in important ways. By itself, democratization will not check corruption in either country, but where reform is accompanied by significant resources and where democratic accountability complements political will--more true of Korea than of the Philippines--significant progress can be made.     

The patient protection and affordable care act: the victory of unorthodox lawmaking

The 2010 Patient Protection and Affordable Care Act was a major legislative achievement of the 111th Congress. This law structurally reforms the US health care system by encouraging universal health care coverage through regulated competition among private insurance companies. When looking at the process for reform, what strikes an observer of US health care policy in the first place is that the Democratic majority was able to enact something in a political field characterized by strong resistance to change. This article builds on that observation. Arguments concentrate on the legislative process of the reform and support the idea that it may be partly explained by considering an evolution of US legislative institutions, mostly in the sense of a more centralized legislative process. Based on approximately one hundred semidirected interviews, I argue that the Democratic majority, building on lessons from both President Bill Clinton's health care reform attempt and the Republicans' strategy of using strong congressional leadership to pass social reforms, was able to overcome institutional constraints that have long prevented comprehensive change. A more centralized legislative process, which has been described as "unorthodox lawmaking," enabled the Democratic leadership to overcome multiple institutional and political veto players.     

The limits of contract law harmonization

Contract law harmonization in the European Union has met with some significant but limited success. This Essay explores some of the psychological and political forces that can complicate or even hinder law reform efforts. Even when there is a general institutional drive for law reform, as there is in the EU, scarce reform resources force attention to be focused on salient issues, while a status quo bias in individual member states by government officials can provide a braking inertia regarding nonsalient legal reforms. This braking influence can be seized upon and enhanced by interest groups that oppose reforms, especially where there is an alternative to proposed law reforms for private entities. In the case of contract law harmonization, contract doctrine that is not focused on providing consumer protections remain nonsalient, commercial entities can solve the confusion of diverse laws by choosing their own, and interest groups in nations whose laws and dispute resolution forums are commonly chosen will oppose harmonization. Thus, the current state of affairs may prove relatively difficult to alter.