Paper/Speech Details of Conference Program for the 17th NISPAcee Annual Conference Program Overview Panel on Health Care, Reforms and Implementation Author(s) Marek Pavlik Masaryk University Brno Czech Republic Title Why none of health reform attempts succeeded? The case of the Czech Republic File Paper files are available only for conference participants, please login first. Presenter Abstract Objective: Although there have been many attempts to start the health reform during past ten years in the Czech Republic; none of these attempts were successfully implemented. The exception is the partial success of the last health reform proposal (2007). The aim of the paper is to analyze two key conditions of initiation of the health reform in the Czech Republic. In other word, the paper will try to answer the question of why the last reform attempt seems to be more successful than previous ones. Considering the complexity of the health reform process the research is narrow down to examination only two of necessary conditions of successful health reform implementation. Author sets two conditions which are examined during the period 1998-2008. The first one is that the cabinet has to have majority in all important representative bodies (i.e. Chamber of deputies, Senate, Regions). This condition is based on assumption that each reform is inevitably tight with accepting new legislation. The second condition is that the Cabinet (fomated by more than one politicla party) has to reach at least 50% agreement on basic health reform principles. There is an assumption that the reform would be postponed in the case of disagreement. Design and settings: The Czech political system and health policy situation are mentioned at the beginning of the paper. Consequences of the cabinet inner heterogenity are also mentioned. The second part of the paper introduces the methods of analysis, which are suggested by the author. The third part of the paper discovers the results of both examined conditions. The results are counted from the cabinet point of view aside from the fact if the cabinet was a coalition type or not. Data and methods: The analysis is based on already published data: results of elections to the Chamber of Deputies, the Senate, regionals’ legislatures; data about members of the Cabinets and theirs members’ political affiliation; pre-election programs of the Cabinet political parties. Author suggested the method which allows displaying the cabinet position in the all lawmaking bodies. The analysis of the second condition – the agreement inside the cabinet coalition is done through analysis of the pre-election programs each of cabinet’s party. Using simple mathematic model was formed “the curve of the coalition cabinet’s concordance rate”. Both results are displayed in chart. Results and conclusion: The main result of analysis is that all Cabinets had minority in all lawmaking bodies except close majority in the Chamber of Deputies since 2002b; and except the second Cabinet formed after the election in 2006 which gained more that 50% in all lawmaking bodies. The curve of the coalition cabinet’s concordance rate shows that all cabinets before the last one (since 2007) reached inner agreement about 25%. The second condition was also fulfilled only by the last Cabinet. There is no doubt of existence more than these conditions and therefore this paper is only part of complex analysis of the Czech health policy. However the extension of nonfulfilment these conditions is surprising and could be explanatory of previous hopeless health reform attempts. Key words: health reform, government, health policy JEL classification: I 1, H 7
