Mainstream western-centric welfare state research has mostly confined itself to studying social policy in consolidated democracies and tends to assume a synergy between democracy and the welfare ...state. This article shifts the focus to welfare states in countries with declining democratic institutions and rising right-wing populist rule to explore a complex relationship between (de)democratization and welfare state reforms. We conduct a comparative case study of two extreme cases of democratic decline, Turkey and Hungary. We employ a sequential mixed method approach. First, we assess welfare efforts in the two countries to understand which policy areas were prioritized and whether autocratizing governments retrenched or expanded their welfare states. In the second stage, we explore the trajectory of welfare reforms in Hungary and Turkey, focusing on three analytically distinguishable dimensions of social policy change: policy content, policy procedures (including timing, parliamentary procedures, veto players); and the discourses accompanying reforms. We find that democratic decline facilitates rapid welfare state change but it does not necessarily mean retrenchment. Instead we observe ambivalent processes of welfare state restructuring. Common themes emerging in both countries are the rise of flagship programmes that ensure electoral support, a transition towards top-down decision-making and the salient role of discourse in welfare governance. Overall, similarities are stronger in procedures and discourse than in the direction of reforms. Differences in spending levels and policy content do not suggest that the two cases constitute a coherent illiberal welfare state regime. Instead, we see the emergence of authoritarian features that modify their original welfare models.
This article focuses on the UN reform within the current architecture of global relations. Firstly, the specialized agencies and organizations and their role in world governance are presented. ...Secondly, the process of reforming the UN, as well as the position of some Indo-Pacific states on this issue are analysed. By exploring the UN activity and the views on the role of this organization of the countries with great economic power and important contributions to its financing the authors wish to draw the attention upon the need for a profound reform and modernization, focusing on common values and priorities and adjusting to the realities which are facing today's societies and the world economy. According to the authors’ opinion, the solutions can be found only through joint political efforts, economic cooperation, multilateralism, social involvement and active intervention to defend peace, without which the existence and the role of the UN and other international bodies could be jeopardized, as well as the very existence of democracy and even the future of humanity.
Recent elections in Europe have shown that a context of increasing citizen distrust towards democratic institutions may lead to very high levels of electoral volatility and to the emergence of new ...parties. On the other hand, institutional reforms are sometimes presented as a solution to citizens' discontent with political institutions. Focusing on a specific type of political institution ‒ electoral systems ‒ the question addressed in this study is whether high levels of electoral volatility may trigger electoral reforms. The article investigates the conditions under which reforms affecting the electoral system's degree of openness to new parties were enacted in 25 European countries between 1945 and 2012. The findings demonstrate that volatility due to the emergence of new parties is the most powerful explanation to account for the introduction of electoral reforms, particularly those that hinder the entry of new parties into the system.
Equity, efficiency, sustainability, acceptability to clients and providers, and quality are the cornerstones of universal health coverage (UHC). No country has a single way to achieve efficient UHC. ...In this study, we documented the Iranian health insurance reforms, focusing on how and why certain policies were introduced and implemented, and which challenges remain to keep a sustainable UHC.
This retrospective policy analysis used three sources of data: a comprehensive and chronological scoping review of literature, interviews with Iran health insurance policy actors and stakeholders, and a review of published and unpublished official documents and local media. All data were analysed using thematic content analysis.
Health insurance reforms, especially health transformation plan (HTP) in 2014, helped to progress towards UHC and health equity by expanding population coverage, a benefits package, and enhancing financial protection. However, several challenges can jeopardize sustaining this progress. There is a lack of suitable mechanisms to collect contributions from those without a regular income. The compulsory health insurance coverage law is not implemented in full. A substantial gap between private and public medical tariffs leads to high out-of-pocket health expenditure. Moreover, controlling the total health care expenditures is not the main priority to make keeping UHC more sustainable.
To achieve UHC in Iran, the Ministry of Health and Medical Education and health insurance schemes should devise and follow the policies to control health care expenditures. Working mechanisms should be implemented to extend free health insurance coverage for those in need. More studies are needed to evaluate the impact of health insurance reforms in terms of health equity, sustainability, coverage, and access.
To evaluate the effects of China's very recent comprehensive pricing healthcare reform, taking the patients' perspective.
Two survey studies were conducted using the same protocol in Beijing in July ...2017 and 2018, respectively.
The same questionnaire was used and contains two sections, with the first on demographic and personal information and the second on various assessments of the reform.
Findings different from those in the government-led evaluations were made. Specifically, the majority of the patients thought the level of medical service fee and cost of medicine still high, and experienced no change or an increase in overall medical cost. The overall assessment of the reform was not sufficiently positive. Multiple problems in healthcare were identified. Development from 2017 to 2018 was not significantly positive.
Patients' assessments of the reform were not as positive as those made in the government-led evaluations. In extending the reform to the whole country, the government and healthcare providers may need to further tune the reform to better serve the public.
•The Chinese government recently implemented a series of healthcare reforms, with the most recent being the comprehensive pricing reform.•A third-party independent evaluation was conducted, focusing on the patients' assessment of the reform.•Findings not as positive as in the published studies are made, suggesting certain limitations of the reform.
Globally, universities are engaged in various aspects of reforms to improve their outlook and relevance. In East Africa, despite the similarities in many dimensions of socio-economic conditions, ...universities vary in terms of focus and extent of engagement in educational reforms. In order to examine this phenomenon more closely, three purposely-selected East African public universities were studied. Analysis of related documents as complemented by responses from key officials of these institutions revealed several findings: the University of Dar es Salaam’s reforms seemed to conform more to characteristics of competitiveness-driven reforms, the University of Nairobi exhibits equity-driven reform, and Makerere University practises finance-driven reforms. Furthermore, the findings register limitations of effective institutional reforms such as massification of higher education, infringement of university autonomy, emerging technologies, paradox of internationalization, and the incapacity to cater to holistic students’ welfare. The study concluded that, despite the myriad of limitations that the universities face, they have numerous opportunities which if efficiently utilized will enable them run the higher education race more triumphantly. The paper recommends that strategies for reforms should not derail the universities from their mandate to serve their respective countries.
During the last 2 decades, two policy reforms-the Fischler Reform and the Common Market Organization Reform-have pushed the EU dairy sector toward economic liberalization. These changes affected the ...EU supply chains at different levels, altering the mechanisms of vertical price transmission. Against this backdrop, we apply error correction models to assess how price signals are passed through before and after the Italian milk supply chain reforms. In particular, we study the degree of price transmission asymmetries and conclude that market sluggishness has increased in the post-reform period, but the asymmetric dynamics are less evident. Reflections on future research needs are discussed.
Why do political actors undertake reforms that constrain their own discretion? We argue that uncertainty generated by political competition is a major driver of such reforms, and test this argument ...using subnational data on Mexican states’ adoption of state-level access to information (ATI) laws. Examining data from 31 Mexican states plus the Federal District, we find that more politically competitive states passed ATI laws more rapidly, even taking into account the party in power, levels of corruption, civil society, and other factors. The fine-grained nature of our data, reflecting the staggered timing of elections, inauguration dates, and dates of passage, allows us to distinguish between different theoretical mechanisms. We find the greatest evidence in favor of an insurance mechanism, by which incumbent parties who face uncertainty over future political control seek to ensure access to government information, and means of monitoring incumbents, in the future in case they lose power.
The coronavirus disease (COVID-19) pandemic has tested the mettle of governments across the globe and has thrown entrenched fault lines within health systems into sharper relief. In response to the ...outbreak of the pandemic, governments introduced a range of measures to meet the growth in demand and bridge gaps in health systems. The objective of this paper is to understand the nature and extent of the changes in health systems triggered by the COVID-19 crisis. The paper examines changes in the role of governments in (1) sector coordination, (2) service provision, (3) financing, (4) payment, and (5) regulations. It outlines broad trends and reforms underway prior to the pandemic and highlights likely trajectories in these aspects in the future. The paper argues that while the pandemic has accelerated changes already underway before the crisis, it has made little headway in clearing the path for other or deeper health policy reforms. The reform window that COVID-19 opened has not been wide enough to overcome the entrenched path dependency and structural interests that characterize the sector.
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