Julian Le Grand

Elias Mossialos

First published in 1999, this volume aims to describe and analyse the experience of cost containment in Europe over the last fifteen years in order to understand that experience and to determine, as best we can, which methods were successful and which were not. Part I provides an overview of healthcare in the European Union, an overview of recent expenditure trends. Part II complements the first, examining in detail cost containment policies in each EU Member State. The country-based chapters refer to developments up to mid-1997.

Health Care and Cost Containment in the European Union

How can we ensure high-quality public services such as health care and education? Governments spend huge amounts of public money on public services such as health, education, and social care, and yet the services that are actually delivered are often low quality, inefficiently run, unresponsive to their users, and inequitable in their distribution. In this book, Julian Le Grand argues that the best solution is to offer choice to users and to encourage competition among providers. Le Grand has just completed a period as policy advisor working within the British government at the highest levels, and from this he has gained evidence to support his earlier theoretical work and has experienced the political reality of putting public policy theory into practice. He examines four ways of delivering public services: trust; targets and performance management; "voice"; and choice and competition. He argues that, although all of these have their merits, in most situations policies that rely on extending choice and competition among providers have the most potential for delivering high-quality, efficient, responsive, and equitable services. But it is important that the relevant policies be appropriately designed, and this book provides a detailed discussion of the principal features that these policies should have in the context of health care and education. It concludes with a discussion of the politics of choice.

Delivering Public Services through Choice and Competition

The Other Invisible Hand

Ray Robinson

The Economics of Social Problems

Richard Titmuss Professor of Social Policy Julian Le Grand

"Uses a detailed empirical examination of policies in health services, education, social security and taxation to illustrate how policies can be designed to give the proper balance of motivation and agency." - cover.

Of Knights and Knaves, Pawns and Queens

Motivation, Agency, and Public Policy

Bill New

Should governments save people from themselves? Do governments have the right to influence citizens' behavior related to smoking tobacco, eating too much, not saving enough, drinking alcohol, or taking marijuana—or does this create a nanny state, leading to infantilization, demotivation, and breaches in individual autonomy? Looking at examples from both sides of the Atlantic and around the world, Government Paternalism examines the justifications for, and the prevalence of, government involvement and considers when intervention might or might not be acceptable. Building on developments in philosophy, behavioral economics, and psychology, Julian Le Grand and Bill New explore the roles, boundaries, and responsibilities of the government and its citizens. Le Grand and New investigate specific policy areas, including smoking, saving for pensions, and assisted suicide. They discuss legal restrictions on risky behavior, taxation of harmful activities, and subsidies for beneficial activities. And they pay particular attention to "nudge" or libertarian paternalist proposals that try to change the context in which individuals make decisions so that they make the right ones. Le Grand and New argue that individuals often display "reasoning failure": an inability to achieve the ends that they set themselves. Such instances are ideal for paternalistic interventions—for though such interventions might impinge on autonomy, the impact can be outweighed by an improvement in well-being. Government Paternalism rigorously considers whether the state should guide citizen decision making in positive ways and if so, how this should be achieved.

Julian Le Grand

About

Books

Join the club