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Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.
In the period from 1970 to the early 1990s, Republican leaders launched three major reforms of the federal system. Although all three initiatives advanced decentralization as a goal, they were remarkably different in their policy objectives, philosophical assumptions, patterns of politics, and policy outcomes. Expanding and updating his acclaimed book, New Federalism: Intergovernmental Reform from Nixon to Reagan (1988), Timothy Conlan provides a comprehensive look at intergovernmental reform from Nixon to the 104th Congress. The stated objectives of Republican reformers evolved from rationalizing and decentralizing an activist government, to rolling back the welfare state, to replacing it altogether. Conlan first explains why conservatives have placed so much emphasis on federal reform in their domestic agendas. He then examines Nixon's New Federalism, including management reforms and revenue sharing; analyzes the policies and politics of the "Reagan revolution"; and reviews the legislative limitations and achievements of the 104th Congress. Finally, he traces the remarkable evolution of federalism reform politics and ideology during the past 30 years and provides alternative scenarios for the future of American federalism.
Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines the overall organization of the health system.
People have always travelled within Europe for work and leisure, although never before with the current intensity. Now, however, they are travelling for many other reasons, including the quest for key services such as health care. Whatever the reason for travelling, one question they ask is "If I fall ill, will the health care I receive be of a high standard?" This book examines, for the first time, the systems that have been put in place in all of the European Union's 27 Member States. The picture it paints is mixed. Some have well developed systems, setting standards based on the best available evidence, monitoring the care provided, and taking action where it falls short. Others need to overcome significant obstacles.
It has been over twenty years since the people of Scotland, Wales and Northern Ireland voted for devolution. Over that time, the devolved legislatures have established themselves and matured their approach to governance. At different times and for different reasons, each has put wellbeing at the heart of their approach – codifying their values and goals within wellbeing frameworks. This open access book explores, for the first time, why each set their goal as improving wellbeing and how they balance the core elements of societal wellbeing (economic, social and environmental outcomes). Do the frameworks represent a genuine attempt to think differently about how devolved government can plan and organise public services? And if so, what early indications are there of the impact is this having on people’s lives?
Exploring the consequences of federal devolution on state budgets, this work deals with three major areas of concern: the effect of moving large numbers of welfare recipients into labour markets; the planned federal reforms in the health care field; and trends in federal aid.
The relationship between ports and governments has changed profoundly over the past quarter of a century. Many governments have sought to extract themselves from the business of port operations and, in many cases, the provision of port services has devolved to local governments, communities or private management and administration. As such devolution implies a change in governance model, this trend raises questions about consequent performance. This issue examines the changed port management environment, focusing particularly on government policies such as devolution, regulatory reform and newly imposed governance models, all of which have exerted a significant influence over the nature of that changed environment. The issue is structured so as to first explore the devolution and port reform approaches for 14 countries or regions, before examining how ports are governed and what the choice of governance might mean for their performance. Part I introduces the issue, and provides a framework for defining the basic concepts involved in devolution; it paints a picture of the current port environment, its likely future evolution and the expected impact this will have on the functioning of ports. Part II examines the port industry in 14 countries or administrations, and presents the thinking behind any devolution programs that have been implemented. Part III focuses on port governance and devolution generally, and examines governance from both strategic management and economics perspectives, including topics such as governance models, supranational governance and stakeholder conflict. Part IV examines the measurement of port performance and closes by providing conclusions and a future research agenda. This issue will be of interest to port managers, government officials and academics alike.*Examines the relationship between ports and governments with a focus on devolution*Divided into sections that provide an overview, evaluate the port industry, disucss port governance, and suggest new measures of port performance*14 countries or regions are addressed
New thinking about the management of public health services has stimulated a widespread movement for health sector reform across the world. This book examines the feasibility and desirability of common reforms in low income countries, based on in-depth case studies in Ghana, Zimbabwe, Sri Lanka, India and Thailand, and asks whether governments possess or can develop the capacities needed for these new and often complex roles. The book challenges conventional reform wisdom, and argues that reform approaches are needed that are more sensitive to the institutional characteristics of individual countries.