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Examining sociopolitical elements of health system reform: The experience of Singapore and Taiwan

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  • Ming‐Jui Yeh
  • Ray Serrano

Abstract

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.

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  • Ming‐Jui Yeh & Ray Serrano, 2020. "Examining sociopolitical elements of health system reform: The experience of Singapore and Taiwan," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(2), pages 649-657, March.
    • Handle: RePEc:bla:ijhplm:v:35:y:2020:i:2:p:649-657
    DOI: 10.1002/hpm.2955
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    References listed on IDEAS

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    1. Rachel Lu, Jui-Fen & Chiang, Tung-Liang, 2011. "Evolution of Taiwan’s health care system," Health Economics, Policy and Law, Cambridge University Press, vol. 6(1), pages 85-107, January.
    2. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
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