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This article traces the process behind the implementation of the “Air Silk Road,” a cargo flight connection between Luxembourg and Zhengzhou, the capital of Henan province. Its origins lie in economic competition between Henan and its neighbouring provinces, dating back a decade before the official announcement of the Air Silk Road in 2017. Provincial and municipal governments in Henan displayed opportunistic risk-taking behaviour in persistently pushing for the development of Zhengzhou's airport economy, but only timing and coincidence allowed the province to gain a foothold in the Belt and Road Initiative (BRI). With findings drawn from fieldwork in China between 2019 and 2020, we contribute to an understanding of the implementation of the BRI, the underlying rationale and the challenges inland provinces face in integrating into the world economy.
Thailand is widely acknowledged as a successful case of achieving universal heath care at modest costs. In this chapter we show that the success is based on a simple system under strong government stewardship: most health services are provided at publicly owned and operated hospitals, and paid for by the government through tax revenues. Layered to the combination of public ownership and funding, is a purchaser-provider split and frequent changes in policy settings based on data on utilisation and costs. The combination of these tools enable the government to monitor quality of services while maintaining a watchful eye on costs. The only tool that Thailand does not use extensively is regulation which, as we will see in this chapter, is not necessarily damaging due to the other tools in place. Public ownership and funding offers sufficient levers to the government to create incentives for healthcare providers to control costs, promote responsiveness, and improve quality of services without the need for extensive regulations.
This chapter discusses the dismantling and rebuilding of the Chinese health care system in recent decades. It shows that China’s reforms over the past decade have focussed on (i) reiterating the role of the government as steward; (ii) promoting policycoordination of various agencies in the sector; (iii) improving the performance public hospitals; (iv) making healthcare providers more responsive to patients’ needs. It will argue that despite these reforms, regulations controlling the quality and safety of drugs and behaviour of providers remain weak and undermine public trust.
The book assesses the policy actions of select Asian governments (China, India, Hong Kong, South Korea, Singapore and Thailand) to address critical health system functions from a policy design perspective. The findings show that all governments in the region have made tremendous strides in focussing their attention on the core issues and, especially, the interactions among them. However, there is still insufficient appreciation of the usefulness of public hospitals and their efficient management. Similarly, some governments have not made sufficient efforts to establish an effective regulatory framework which is especially vital in systems with a large share of private providers and payers. A well-run public hospital system and an effective framework for regulating private providers are essential tools to support the governance, financing, and payment reforms underway in the six health systems studied in this book.