This book is a welcome addition to the literature and follows a line of books and articles produced by Ramesh and colleagues on health policy in Asia and elsewhere. The book has a strong public policy underpinning, which is valuable for those interested in the policy process, policy change, and outcomes. And what better sector (health) and region in the world (Asia) to be focused on to draw a series of case studies against which to evaluate policy frameworks, tools, and progress?
The central premise of the book, as indicated in the title, is the development and application of a policy design approach. This is a very important concept, as the authors note, given the gradual convergence in focus across countries on universal health care and a series of other key health policy goals. The design approach has its roots in design thinking and, for the purposes of the book, a focus on addressing challenges through the selection of the best policy tools available, and doing so with a specific intent in mind. As the authors note, the design approach has risen out of the response to failures of the era driven by neoliberal policy and the development of competitive market models for health care organization, and the rather negative impact this has had across the globe through ubiquitous application from the 1990s onward. Thus, design approaches are focused on how to, for example, better coordinate services within the health system, how to improve service access (particularly for poorer people), and how to build better population-based planning and service delivery. The book has an overriding focus on the analysis of the expansion of universal health care.
The authors analyze the case studies through a framework based on five core functions of a health system: governance (stewardship and coordination), provision (public and private ownership), financing (risk pooling), payment (retrospective and prospective), and setting standards (regulation). Each of these functions and its characteristics are described in some detail in the opening chapter, including the nature of the various manifestations that are likely to be found in a health system. The case studies are selected for the variations within and between them, including the mix of public and private service delivery and different funding mechanisms. There are chapters on two large countries, China and India; two middle-sized countries, South Korea and Thailand; and two city-states, Hong Kong and Singapore. Each of these case study chapters follows a narrative based on the framework, so they are very useful reading in themselves, providing a range of insights around the differences between the cases and the nuances of health policy and planning in each.
Overall, the book provides rich information on all of the cases, which are constructed out of significant in-depth fieldwork and analysis. It teases out the various ways in which health policy plays out in different contexts, and it will be particularly useful for students and teachers of health policy and systems as well as those with an interest in this region. Very importantly, the book brings analysis of the postneoliberal era to the table and shows how different parts of Asia have responded in the effort to expand universal health coverage. It shows how policy has evolved, including how government has increasingly focused on improvement and innovation across the spectrum of areas that the framework encapsulates. For such a vast and important area of the world, which is home to a significant proportion of the global population, it is useful to have this information in one place. One of the key goals now for the publisher and the authors is to get this book into the hands of policy makers around the region and elsewhere. While policy makers may disagree over many areas, one commonality they share is their journey toward health care improvement. In this regard, the book's key contribution via the design approach should resonate with all. The book will also help them continue to draw lessons from one another.