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Examining sociopolitical elements of health system reform: The experience of Singapore and Taiwan
Author(s) -
Yeh MingJui,
Serrano Ray
Publication year - 2020
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.2955
Subject(s) - legitimacy , politics , equity (law) , corporate governance , government (linguistics) , solidarity , political science , public administration , political system , sociology , economic growth , political economy , economics , democracy , philosophy , finance , linguistics , law
Summary This essay suggests five sociopolitical dimensions that influence the success of health system reforms. It examines the experience of two high‐income Asian countries, Singapore and Taiwan, and illustrates how these five dimensions matter. These five sociopolitical dimensions are public trust, perceived government performance, political legitimacy, equity/solidarity, and demand for choice. Public trust in government, perceived government performance, and the legitimacy of political authorities were necessary for governments in both countries to enact key reforms. Public perceptions of government capacity combined with public conceptions of equity were deliberated and clarified as stakeholders sought to reach consensus based on values upheld by segments of each society. Nevertheless, these elements alone are not enough to sustain major institutional reforms in light of ongoing social, political, and demographic changes. This essay provides a different approach to traditional policy cycle models and seeks to emphasize stewardship and governance in health systems.