Kieke G Okma – författare

This book presents the health reform experiences over the past three decades of twelve small and medium-sized nations that are not often included in international comparative studies in this field. The major conclusion of the study is that despite many similarities in policy goals, policy challenges and in the menu of policy options for countries that seek to offer universal coverage to their population, the health reforms of the nations in this book did not converge into one direction or model. However, we found several widespread policy experiences that are relevant for others, too.For example, user fees are unpopular everywhere. Governments often try to soften the consequences by exempting large groups of users, thus largely defeating the very purpose of those fees.As a second example, the introduction of new payment modes for medical care — like the shift from fee for service to case-based payment — took much longer than originally expected everywhere, and also failed to deliver their promises of improved transparency or efficiency gains A third example is that proposals are for universal coverage often ignore the challenges of implementing new financing models that elsewhere took decades if not centuries to develop.The conclusions contain both empirical findings and theoretical conclusions of interest to policy-makers and scholars of international comparison. It is accessible for academics, healthcare managers and students as well as a wider audience of readers interested in the changes in healthcare across the world.

This book presents the health reform experiences over the past three decades of twelve small and medium-sized nations that are not often included in international comparative studies in this field. The major conclusion of the study is that despite many similarities in policy goals, policy challenges and in the menu of policy options for countries that seek to offer universal coverage to their population, the health reforms of the nations in this book did not converge into one direction or model. However, we found several widespread policy experiences that are relevant for others, too.For example, user fees are unpopular everywhere. Governments often try to soften the consequences by exempting large groups of users, thus largely defeating the very purpose of those fees.As a second example, the introduction of new payment modes for medical care — like the shift from fee for service to case-based payment — took much longer than originally expected everywhere, and also failed to deliver their promises of improved transparency or efficiency gains A third example is that proposals are for universal coverage often ignore the challenges of implementing new financing models that elsewhere took decades if not centuries to develop.The conclusions contain both empirical findings and theoretical conclusions of interest to policy-makers and scholars of international comparison. It is accessible for academics, healthcare managers and students as well as a wider audience of readers interested in the changes in healthcare across the world.

This book presents the healthcare reform experiences of six small- to mid-sized, but dynamic, economies spanning the Asia-Pacific, the Middle East and Europe. Usually not given serious consideration in major international comparisons because of their small size, each in fact provides a fascinating case study that illuminates the understanding of the dynamics of healthcare reform. Although dissimilar in historical and cultural backgrounds, they share some important features: all faced very similar pressures for change in the 1970s and 1980s; all considered a very similar range of policy options; and all did not only discuss but actually implemented fundamental changes in their healthcare funding, organization, contracting and governance structures with strikingly different outcomes.All of the authors have lived and worked in one or more of the countries studied in this volume. The analytic frameworks they use reflect their broad range of professional and disciplinary backgrounds in health economics and political science. Beyond mere descriptions of reform processes and superficial analyses based on aggregate data from the usual OECD or WHO sources, they seek to understand — and explain — the variations in country experiences by examining the politico-socio-economic factors driving health reform as seen through the respective country lenses. In coming together in this unique international collaboration, they make an important contribution to the growing field of international comparative health policy studies.Contributors: Tsung-Mei Cheng (Princeton University, USA), David Chinitz (The Hebrew University of Jerusalem, Israel), Luca Crivelli and Iva Bolgiani (University of Lugano, Switzerland), Meng-Kin Lim (National University of Singapore, Singapore), Kieke G H Okma and Hans Maarse (Maastricht University, The Netherlands), Toni Ashton and Tim Tenbensel (University of Auckland, New Zealand).