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A network approach for researching political feasibility of healthcare reform: The case of universal healthcare system in Taiwan

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  • Wang, Guang-Xu

Abstract

This study evaluates the political feasibility of healthcare reform taking place in Taiwan in the past decade. Since Taiwan adopted National Health Insurance (NHI) in 1995, it has provided coverage for virtually all of the island's citizens. However, the imbalance between expenditure and revenue has resulted in a cycle of unsustainable spending which has necessitated financial reforms and political confrontations. By applying social network analysis, this paper examines multiple types of ties between policy elites and power distribution that have evolved in crucial policy events of the NHI's financial reforms between 1998 and 2010. Data sources include official documents and 62 social network interviews that were held with government officials and related unofficial policy participants. Blockmodeling and multidimensional scaling (MDS) are used to determine the major participants and network structures in the NHI domain, as well as the influential policy actors, based on information transmission, resource exchange, reputation attribution and action-set coalition networks in Taiwan's current political situation. The results show that although both public actors and all medical associations are the leading actors in the NHI reform, without good communication with societal actors, the promotion of reform proposals ends in failure. As a tool of political feasibility evaluation, social network analysis can map the political conflict between policy stakeholders systematically when policy makers pursue the result of policy adoption.

Suggested Citation

  • Wang, Guang-Xu, 2012. "A network approach for researching political feasibility of healthcare reform: The case of universal healthcare system in Taiwan," Social Science & Medicine, Elsevier, vol. 75(12), pages 2337-2344.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:12:p:2337-2344
    DOI: 10.1016/j.socscimed.2012.09.005
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    References listed on IDEAS

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    1. Keith Dowding, 2001. "There Must Be End to Confusion: Policy Networks, Intellectual Fatigue, and the Need for Political Science Methods Courses in British Universities," Political Studies, Political Studies Association, vol. 49(1), pages 89-105, March.
    2. Walsh, Julia & Simonet, Maryse, 1995. "Data analysis needs for health sector reform," Health Policy, Elsevier, vol. 32(1-3), pages 295-306.
    3. Aarons, G.A. & Wells, R.S. & Zagursky, K. & Fettes, D.L. & Palinkas, L.A., 2009. "Implementing evidence-based practice in community mental health agencies: A multiple stakeholder analysis," American Journal of Public Health, American Public Health Association, vol. 99(11), pages 2087-2095.
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    Cited by:

    1. Lau, Manfred & Larkin, Charles & Harty, Michael & Corbet, Shaen, 2021. "Creating universal health care in Ireland: A legal context," Health Policy, Elsevier, vol. 125(6), pages 777-785.

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