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首页> 外文期刊>Israel Journal of Health Policy Research >Policy entrepreneurship and policy networks in healthcare systems – the case of Israel’s pediatric dentistry reform
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Policy entrepreneurship and policy networks in healthcare systems – the case of Israel’s pediatric dentistry reform

机译：医疗体系中的政策企业家精神和政策网络-以色列的儿科牙科改革案例

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BackgroundCan the entry of a policy entrepreneur challenge the equilibrium of a policy network and promote changes that might clash with the goals of powerful civil-servants and/or interest groups and, if so, why and how? Our goal is to examine two sides of the same coin: how does an in-depth analysis of Israel’s dental care reform enrich our understanding of policy networks and policy entrepreneurship? Second, how does the literature on policy networks and policy entrepreneurship help us understand this reform? Based on a theoretical framework that appears in the literature of policy entrepreneurship and policy networks, we analyze the motivations, goals and strategies of the main actors involved in the process of reforming pediatric dental care in Israel. We demonstrate how a policy entrepreneur navigated within a policy network and managed to promote a reform that, until his appearance, no one else in that network had succeeded in enacting. MethodsOur goals are advanced through a case study of a reform in pediatric dentistry implemented in Israel in 2010. It rests on textual analyses of the literature, reports, committee minutes, parliamentary proceedings, print and online media, and updates in relevant legislation and case law between 2009 and 2015. In addition, the case study draws on the insights of one of the authors (TH), who played a role in the reform process. ResultsHistorical circumstances and the Israeli public’s longstanding lack of interest in changing the existing model as well as interest groups that preferred the dominance of the private sector in the dental healthcare system kept that area out of the services supplied, universally, under the National Health Insurance Law. This situation changed significantly following the publication in 2007 of a policy analysis that contributed to shifts in the motivations and balance of power within the policy network, which in turn prepared the ground for a policy change. In this environment a determined policy entrepreneur, who identified a window of opportunity, took the lead and instituted an innovative and far-reaching reform. ConclusionsA policy entrepreneur can leverage external factors as well as the previous activities of a policy network that has already matured to create a policy change. Such entrepreneurial activity includes maneuvering around opponents and overcoming resistance from various stakeholders.
机译：背景知识政策企业家的进入能否挑战政策网络的平衡并促进可能与强大的公务员和/或利益集团的目标相抵触的变化？如果是，原因和方式是什么？我们的目标是研究同一问题的两个方面：对以色列牙科保健改革的深入分析如何丰富我们对政策网络和政策企业家精神的理解？第二，关于政策网络和政策企业家精神的文献如何帮助我们理解这项改革？基于政策创业和政策网络文献中出现的理论框架，我们分析了以色列小儿牙科保健改革过程中主要参与者的动机，目标和策略。我们展示了一位政策企业家如何在政策网络中导航并设法推动一项改革，直到他出现之前，该网络中没有其他人能够成功颁布这一改革。方法我们通过对2010年在以色列实施的儿科牙科改革进行案例研究来实现我们的目标。该研究基于对文献，报告，委员会会议记录，议会程序，印刷和在线媒体的文字分析，以及有关立法和判例法的更新在2009年至2015年之间。此外，该案例研究还借鉴了一位在改革过程中发挥作用的作者（TH）的见解。结果历史情况和以色列公众长期以来对改变现有模式缺乏兴趣，以及利益集团更倾向于在牙科医疗体系中占据私营部门的主导地位，这使该领域无法根据《国家健康保险法》普遍提供。在2007年发布了一项政策分析之后，这种情况发生了重大变化，这一政策分析推动了政策网络内动机和力量平衡的转变，从而为政策变革奠定了基础。在这种环境下，坚定的政策企业家找到了机会之窗，他率先进行了创新且意义深远的改革。结论决策者可以利用外部因素以及已经成熟的策略网络的先前活动来创建策略更改。这种创业活动包括在对手周围回旋和克服各种利益相关者的抵制。

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