M- Ramesh

National University of Singapore | NUS · Lee Kuan Yew School of Public Policy

Policy design studies typically focus on broad policy goals and the types of tools that governments use to realize them. There is however limited scholarly understanding of how these goals and tools are operationalized "on-the-ground. " In this paper, we apply Capano and Howlett's 2024 Framework on the Micro-Dimensions of Policy Design to understan...

Policy studies have addressed many issues on the topic of policy change, generally following the ideas about policy composition set out by Hall and others. These typically view 'significant' policy change as related to alterations in the macro elements of policies, namely policy paradigms and governance preferences. These studies have also examined...

Primary care is often the weakest link in health systems despite its acknowledged central importance in promoting population's health at economical cost. A key reason for the lacunae is that both scholars and practitioners working on the subject typically underestimate the enormity of the task and the range of complementary measures required to bui...

Policy advice has been the subject of ongoing research in the policy sciences as it raises fundamental issues about what constitutes policy knowledge, expertise, and their effects on policymaking. This introduction reviews the existing literature on the subject and introduces the themes motivating the articles in the issue. It highlights the need t...

Policy advice has been the subject of ongoing research in the policy sciences as it raises fundamental issues about what constitutes policy knowledge, expertise, and their effects on policymaking. This introduction reviews the existing literature on the subject and introduces the themes motivating the articles in the issue. It highlights the need t...

Fee-for-service remains a popular mode of paying for healthcare despite widespread knowledge of its ill effects. This has resulted in a gap between policy knowledge (understood as consensus among experts) and policy practice (actual policy measures to implement the consensus) in healthcare. The existing literature attributes such gaps to a range of...

While policy design scholars have made significant conceptual and empirical advances in identifying and evaluating procedural tools, there has been a little focus on understanding how they interact with the more traditional “substantive” elements of a policy mix and their critical functions in policy mix designs. As a result, there is uncertainty a...

p> A key challenge to real-world policy making is determining how to match policy goals with the means available to implement them. This match is problematic for several reasons, not the least of which is the lack of conceptual clarity surrounding how targets should be set for policy goals and how exactly policy tools should be calibrated to meet...

p> A key challenge to real-world policy making is determining how to match policy goals with the means available to implement them. This match is problematic for several reasons, not the least of which is the lack of conceptual clarity surrounding how targets should be set for policy goals and how exactly policy tools should be calibrated to meet...

Governments across the globe have made repeated attempts to reform their health systems in recent decades with the purpose of improving access while containing costs. What is the role of government in contemporary health policy in achieving these somewhat contradictory goals? This paper conceptualises this role as one of "active stewardship" wherei...

The coronavirus (COVID-19) pandemic has once again highlighted the importance of social inequalities during major crises, a reality that has clear implications for public policy. In this introductory article to the thematic issue of Policy and Society on COVID-19, inequalities, and public policies, we provide an overview of the nexus between crisis...

The coronavirus disease (COVID-19) pandemic has tested the mettle of governments across the globe and has thrown entrenched fault lines within health systems into sharper relief. In response to the outbreak of the pandemic, governments introduced a range of measures to meet the growth in demand and bridge gaps in health systems. The objective of th...

Policy tools are chosen and deployed in the expectation that they will continue to work effectively over extended periods of time. This is a tall expectation to meet, given that the nature of policy problems and their contexts change constantly. To continue to operate effectively in the face of these changes and respond to policy feedback from poli...

This paper offers an analysis of the theoretical and empirical challenges the coronavirus pandemic poses for theories of policy change. Critical events like coronavirus disease are potentially powerful destabilizers that can trigger discontinuity in policy trajectories and thus are an opportunity for accentuating path shifts. In this paper, we argu...

Policy tools are a critical part of policy-making, providing the ‘means’ by which policy ‘ends’ are achieved. Knowledge of their different origin, nature and capabilities is vital for understanding policy formulation and decision-making, and they have been the subject of inquiry in many policy-related disciplines and sector-specific studies. Yet ma...

Après avoir laissé la question de côté pendant des décennies, le gouvernement indien a lancé en 2008 un programme national d’assurance maladie pour répondre aux besoins de la majeure partie de la population qui ne pouvait pas s’offrir des soins de santé. Ce programme a été suivi par le lancement d’un autre programme national en 2018, qui élargissai...

A recent resurgence of interest in policy design has fostered renewed efforts to better understand how specific combinations of policy tools arise and shape policy outcomes. However, to date, these efforts have been stymied by under-theorization of the dif- ferent purposes to which tools are directed in policy mixes and a corresponding failure to a...

After decades of neglect, in 2008, the Indian government launched a national health insurance programme to address the needs of the bulk of the population that could not afford healthcare. This was followed by the launch of another national programme in 2018 that further expanded insurance coverage. These schemes envision a large single-payer, insu...

The past decade has witnessed the emergence of many technologies that have the potential to fundamentally alter our economic, social, and indeed personal lives. The problems they pose are in many ways unprecedented, posing serious challenges for policymakers. How should governments respond to the challenges given that the technologies are still evo...

Three specifi c aspects of governance are critical in understanding the di erences between governance styles and their impact of policy-making styles: dynamics , strategy and capacity. The notion of governance dynamic s suggests that styles of governance identifi ed in earlier studies may not be stable but rather dynamic. These change over the cour...

Getting the incentives (and disincentives) right in order to ensure proper levels of compliance with government initiatives is a vital assumption of much of the writings on policy design. The assumption, however, overlooks or underestimates other critical factors that affect compliance. This includes policy-makers' behaviour in the social and polit...

The objective of this collection of essays is to gain insights into the different national-level state responses to COVID-19 around the world and the conditions that shaped them. The pandemic offers a natural experiment wherein the policy problem governments faced was the same but the responses they made were different, creating opportunities for c...

Collaborative arrangements such as co-production, co-management, consultations, contracting-out, commissioning and certification in recent years have been at the centre of efforts to re-think and improve the provision of public services. Unfortunately, lost in the discussion of the possible benefits of these alternative modes of service delivery ha...

Singapore’s healthcare system ranks among the best in the world in terms of infant mortality rate, longevity, disability adjusted years, and so on. What is most remarkable, however, is that it achieved these fine outcomes at less than half the costs in comparable countries. The achievement of high healthcare outcomes at low costs is what constitute...

The new design orientation in the policy sciences has placed renewed emphasis on problem-solving and developing effective public policies. In this paper, we contribute to this scholarship by presenting a policy framework on anticipating effective policies. We argue that anticipation – that is, foreseeing the future and preparing for it – must be ce...

Policy design involves deliberate decisions about the choice of policy instruments and their optimal configurations for producing desired policy outcomes. Understanding the causal logic through which instruments influence actors to behave in ways consistent with overarching policy goals is critical for success. public–private partnership (PPP) has...

CALL FOR PAPERS Research Workshop on: (Re) Imagining Policy Tools: New Directions in Theory and Practice Yonsei University Seoul March 15-16, 2019 Convenors: M Ramesh and Araz Taeihagh, National University of Singapore, Michael Howlett, Simon Fraser University, Canada, M. Jae Moon, Yonsei University, Korea The recent proliferation of interest in po...

Policy design efforts are hampered by inadequate understanding of how policy tools and actions promote effective policies. The objective of this book is to address this gap in understanding by proposing a causal theory of the linkages between policy actions and policy effects. Adopting a mechanistic perspective, the book identifies the causal proce...

The past two decades have witnessed unprecedented policy effort to improve access to medical services and strengthen financial protection from catastrophic healthcare expenditure. Despite billions of dollars in health spending, many – especially across the developing world – continue to remain vulnerable to financial impoverishment. What accounts f...

Collaboration – and its cognates consultative in-house service delivery, contracting out, commissioning, co-management, co-production, and third party certification – have in recent years been at the center of efforts to reform the public sector and devolve its capacity for policy implementation and service delivery. While the arguments in support...

From “alternative facts” to “fake news,” in recent years the influence of misinformation on political life has become amplified in unprecedented ways through electronic communications and social media. While misinformation and spin are age-old tactics in policy making, and poor information and poorly informed opinion a constant challenge for policy...

How best to deal with uncertainty and surprise in policy-making is an issue which has troubled policy studies for some time. Studies of policy uncertainty and policy failure have emphasized the need to create policies able to be improvised upon in the face of an uncertain future, meaning there is a need to design and adopt policies featuring agilit...

Published works on health insurance tend to focus on program design and its impact, neglecting the implementation process that links the two and affects outcomes. This paper examines the National Health Insurance [Rashtriya Swasthya Bima Yojana (RSBY)] in India with the objective of assessing the role of implementation structures and processes in s...

Please send proposals (500 words) along with authors’ names, institutional affiliations, and list of relevant publications to Araz Taeihagh at govemergingtech@gmail.com no later than September 30, 2018.

The purpose of this paper is to improve knowledge of the transnational diffusion of public policies. It argues that existing studies on the subject do not provide an adequate understanding of the mechanisms through which diffusion takes place, nor do they sufficiently address the roles specific organizations and individuals play in driving or deter...

The purpose of this study is to understand the role of international and domestic actors, ideas and processes in the diffusion of public policies. It argues that existing studies on the subject do not provide an adequate explanation of the mechanisms through which diffusion takes place, nor do they sufficiently address the roles of actors affecting...

Are policy work and the capacities required in developing countries different from those in the developed world? This article addresses this question using data from a survey of policy professionals in the Philippines. The individuals surveyed have similar characteristics as their counterparts in developed countries, but their specific policy analy...

Although policy capacity is among the most fundamental concepts in studying public policy, there are considerable disagreements on its conceptual definitions and few systematic efforts to operationalize and measure it. This chapter presents a conceptual framework for analyzing and measuring policy capacity under which policy capacity refers to the...

This book provides unique insights into the role of policy capacity in policymaking and policy change, as it is being uncovered at the research frontier in contemporary policy studies. The book is structured into a series of sections on policy capacity in theory and practice, each focusing on a specific aspect of policy capacity and its influence o...

Healthcare reforms often result in disappointing failures due to the misguided goals they pursue and the flawed means they employ. The paper proposes that effectiveness—defined as universal access to essential healthcare at a cost affordable to society—is a worthwhile and achievable objective. But to realize effectiveness, reformers need to discard...

This article addresses the rise of design thinking and its problematics in the social policy sphere. In particular, it argues that studies of social policy design, like all design work in policymaking, must differentiate more carefully between technical and political considerations in public policymaking and examine the implications each process ha...

Decentralization reforms rarely live up to the high hopes and expectations of the reformers for a variety of reasons rooted in actions and omissions of the governments pursuing it or in the context in which it is undertaken. The paper examines the experience of Zhejiang Province where decentralization was successful in achieving and indeed exceedin...

This article assesses the usefulness of conceptions of policy capacity for understanding policy and governance outcomes. In order to shed light on this issue, it revisits the concept of governance, derives a model of basic governance types and discusses their capacity pre-requisites. A model of capacity is developed combining competences over three...

Policy design, or the deliberate governmental effort to attain desired policy objectives, is an integral part of micro and macro-level fiscal and financial regulation. This paper seeks to address the role of regime coherence and policy capacity in contributing to effective financial policy design. Drawing on the cases of the Global Financial Crisis...

While it is widely agreed that local governments played a critical role in infrastructure building and industrial development in China—the key factors in its “economic miracle”—the relationship between local government entrepreneurship and the development of specialised markets through which products made in China are marketed to buyers worldwide i...

There is no denying that policy actors matter in driving policy change. Most of the policy process frameworks argued for the centrality of policy actors but have similarly contended that the occurrence of policy change is contingent upon the dynamic interaction of policy actors, organizations and institutions. But the roles played by the actors in...

This paper proposes to integrate disparate notions of governance capacity by adopting a resource-based view of capacity. Governance capacity can be defined as the set of organizational and systemic resources necessary to make sound policy choices and implement them effectively. Adopting this definition allows for a more nuanced conceptualization of...

This article evaluates the efforts underway in India to achieve universal health care coverage and the conditions that fostered its contemporary evolution. It finds that India's health system is characterized by private provision and financing, horizontal and vertical fragmentation, and weak governance arrangements. The article argues that these de...

Although policy capacity is among the most fundamental concepts in public policy, there is considerable disagreement over its definition and very few systematic efforts try to operationalize and measure it. This article presents a conceptual framework for analysing and measuring policy capacity under which policy capacity refers to the competencies...

This paper conceptualizes political competences at the system level of capabilities to function as "legitimation capacity" in a policy context. It identifies trust in the political, social, economic, and security spheres as the key element driving this capacity. Trust ensures that state actions and institutions are perceived as legitimate and recei...

In many visions of governance, governments are portrayed as playing a “steering”, rather than “rowing”, role. The widespread use of privatization, deregulation, decentralization and third-party governments are often mentioned as concrete manifestations of the broad transformation which has led to new forms of governance. Examined more closely, howe...

The persistence of policy failures is a recognized but not well-understood phenomenon in the literature of the policy sciences. Existing studies offer only limited insights into the persistence of policy failures as much of the literature on the subject to date has focused on conceptualizing the topic and differentiating between different types of...

India’s first health policy document in 1946 envisaged an ambitious health system comprising delivery of public health programs by the national governments and primary and secondary care by the state governments. Nearly seven decades later, neither of the ambitions have been realised. The delivery of public health programs is limited and uncoordina...

The objective of the paper is to assess the usefulness of conceptions of different modes of governance for understanding policy outcomes by studying the experience with hierarchical and non-hierarchical governance modes in the health care sector in China, India, and Thailand. The paper shows their experience with non-hierarchical modes to have been...

Governance is not a fashion, but a firmly established lens through which to analyse the complexity of contemporary policy-making, that is the way in which a society and its political processes are organized and steered. Thus, governance needs to be seen as a general concept within political analysis that represents a necessary, heuristic tool with...

“Anything but the government” has been a popular sentiment in public policy circles for at least two decades. Initially, the sentiment favoured transitions from governments to market-based governance regimes but the tilt has shifted towards transition from governments to network governance in recent years (for discussion of the key relevant concept...

"The study of governance may be currently in fashion, but it is also a firmly-established lens through which the complexities of contemporary policy making can be analysed while examining the ways in which a society and its political processes are organized and steered. Governance thus needs to be seen as a general concept within political analysis...

Perceptions of the pervasive and persistent failures of governments in many issue areas over the past several decades have led many commentators and policy makers to turn to non-governmental forms of governance in their efforts to address public problems. During the 1980s and 1990s, market-based governance techniques were the preferred alternate fo...

Proper roles for government and market in addressing policy problems may be assessed by considering the duality between market imperfections and government imperfections. The potential of government interventions or market mechanisms as core policy instruments can be eroded by fundamental deficiencies deeply rooted in either government or market as...

The extent to which social protection programmes in general, and targeted programmes in particular, actually alleviate poverty has been a central issue in development debates for decades. The objective of this article is to contribute to the debate by empirically examining the poverty-alleviation effects of one of the largest targeted programmes in...

The paper examines social protection programmes for the poor, aged and sick in Indonesia and the Philippines with the purpose of assessing their performance in effectively protecting the population. This comparative review indicates that both countries have made major advances in improving health coverage and maintaining income for the chronic poor...

This study assesses the usefulness of conceptions of policy capacity for understanding policy and governance outcomes. In order to shed light on this issue, we revisit the concept of governance, derive a model of governance types and discuss their capacity pre-requisites. A model of capacity is developed combining competences or skills over three l...

The purpose of this paper is to analyse and assess health care reforms in Vietnam since the late 1980s. It will argue that shortcomings of the reforms centre on three related sets of measures: substitution of budgetary allocation with user charges, expansion of social insurance and promotion of decentralisation. Reduction in fiscal support for prov...

This article examines the role of health governance in shaping the outcomes of healthcare reforms in China. The analysis shows that the failure of reforms during the 1980s and 1990s was in part due to inadequate attention to key aspects in health governance, such as strategic interactions among government, providers and users, as well as incentive...

This short guide provides a concise and accessible overview of the entire policy cycle taking the reader through the various stages of agenda setting, policy formulation, decision making, policy implementation and policy evaluation.

The government of Hong Kong has been trying to reform the territory's health care financing system since the early 1990s and is finally on the verge of succeeding. The objective of this paper is to assess the reform efforts and explain the causes of repeated failures and eventual success. It will argue that the government's fortunes changed only af...

Regulation of public infrastructure has been a topic of interest for more than a century. Providing public goods, securing their financing, maintenance, and improving the efficiency of their delivery, has generated a voluminous literature and series of debates. More recently, these issues have again become a central concern, as new public managemen...

Students of Canadian political economy are faced with assimilating and assessing critically a wealth of detailed research on Canadian political and economic life, from the left-leaning work of staples theorists to the countless right-wing studies produced by think-tanks like the Fraser Institute. In this completely revised, updated, and enlarged se...

The objective of this paper is to survey the social consequences of the 1997 Asian financial crisis with the purpose of drawing policy lessons. The outbreak of the financial crisis and the ensuing increase in unemployment and poverty triggered a worsening of education and health outcomes. The situation stabilized and eventually improved only after...

This manual provides guidance on how to formulate public policies with a view to advancing sustainable development. It uses the stylised policy cycle as the basis and brings in several aspects of integration: integration of policy goals across social, economic and enviromental dimentions, integration of policy tools, and integration of various desc...

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Declining access to health care and rapidly rising health expenditures are a matter of grave public concern in China. After decades of efforts to reduce its involvement, the Chinese government is currently in the process of reforming the sector through increase in public expenditures and expansion of health insurance. The objective of this paper is...

ABSTRACT Market-oriented reforms in the health sector continue to dominate health policy agendas in many developing countries despite growing evidence of their negative impacts. This article critically examines eight key arguments that are used to justify market-oriented reforms and that continue to hold widespread appeal among policy makers and an...