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Affordable Excellence Cover

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Affordable Excellence

The Singapore Healthcare Story

William A. Haseltine

This is the story of the Singapore healthcare system: how it works, how it is financed, its history, where it is going, and what lessons it may hold for national health systems around the world. Singapore ranks sixth in the world in healthcare outcomes, yet spends proportionally less on healthcare than any other high-income country. This is the first book to set out a comprehensive system-level description of healthcare in Singapore, with a view to understanding what can be learned from its unique system design and development path.

The lessons from Singapore will be of interest to those currently planning the future of healthcare in emerging economies, as well as those engaged in the urgent debates on healthcare in the wealthier countries faced with serious long-term challenges in healthcare financing. Policymakers, legislators, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think tanks should understand how the Singapore system works to achieve affordable excellence.

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Afghan Lessons

Culture, Diplomacy, and Counterinsurgency

translated by Angela Arnone. Fernando Gentilini

Fernando Gentilini served nearly two years as the civilian representative of NATO in Afghanistan, running a counterinsurgency campaign in the wartorn nation. Afghan Lessons is the fascinating story of his mission, a firsthand view of Afghanistan through a kaleidoscope. He explores Afghan history, literature, tradition, and culture to understand some of the most basic questions of Western involvement: What is the purpose? What does an international presence mean, and how can it help?

Highlights from Afghan Lessons

"This is a book about different worlds, different realities. The reality of everyday life in an unreal world. People that need to be looked after, jobs that need to be done, a country that needs to be restored, all from within the necessary confines of an armed camp. And this in the middle of another reality, which we do not understand, full of things forgotten under decades of war. The keys to this reality lie in the past, perhaps lost." —from the Foreword by Robert Cooper

"To tempt me to explore their country, the Afghans kept repeating that there were three different Afghanistans: 'The first is the one you Westerners imagine; another coincides with the city of Kabul; the third is the country of remote provinces, far away from the cities, and of the three, this is the only real Afghanistan.'"

"'There can be no development without security and no security without development.' ... Everyone said it over and over again, both the civilians and the military, but depending on whether it was said by the former or the latter, the emphasis was placed on the first or second part of the slogan. In all honesty this seemingly obvious concept concealed two contrasting ways of seeing things."

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Africa’s Deadliest Conflict

Media Coverage of the Humanitarian Disaster in the Congo and the United Nations Response, 1997–2008

Africa’s Deadliest Conflict deals with the complex intersection of the legacy of post-colonial history—a humanitarian crisis of epic proportions—and changing norms of international intervention associated with the idea of human security and the responsibility to protect (R2P). It attempts to explain why, despite a softening of norms related to the sanctity of state sovereignty, the international community dealt so ineffectively with a brutal conflict in the Democratic Republic of the Congo, which between 1997 and 2011 claimed an estimated 5.5 million. In particular, the book focuses on the role of mass media in creating a will to intervene, a role considered by many to be the key to prodding a reluctant international community to action.

Included in the book are a primer on Congolese history, a review of United Nations peacekeeping missions in the Congo, and a detailed examination of both US television news and New York Times coverage of the Congo from 1997 through 2008. Separate conclusions are offered with respect to peacekeeping in the Age of R2P and on the role of mass media in both promoting and inhibiting robust international responses to large-scale humanitarian crises.

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Against the Tide

Household Structure, Opportunities, and Outcomes among White and Minority Youth

Carolyn J. Hill, Harry J. Holzer, and Henry Chen

Hill, Holzer, and Chen examine the effects of household structure on youth and young adults and how these effects might have contributed to the negative trends in outcomes observed for young minorities over time.

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Agents of Change

Strategy and Tactics for Social Innovation

Sanderijn Cels, Jorrit de Jong, and Frans Nauta

While governments around the world struggle to maintain service levels amid fiscal crises, social innovators are improving social outcomes for citizens by changing the system from within. In Agents of Change, three cutting-edge thinkers and entrepreneurs present case studies of social innovation that have led to significant social change. Drawing on original empirical research in the United States, Canada, Japan, Germany, Denmark, and the Netherlands, they examine how ordinary people accomplished extraordinary results.

Sanderijn Cels, Jorrit de Jong, and Frans Nauta offer lively illustrations and insightful interpretations of how innovators, social entrepreneurs, and change agents are dealing with powerful opponents, the burdens of bureaucracy, and the challenge of securing resources and support. This book will appeal to anyone who is intrigued by imaginative, cross-boundary thinking and transformative change. It will be of particular interest to those who want to know how exactly innovators pull it off. With practitioners, scholars, and students of public policy and management in mind, the authors dissect the strategies and tactics that social innovators employ to navigate the risky waters of their institutional environments.

Contents Part 1: Introduction: Chess Masters and Acrobats 1. Strategy and Tactics

2. Crafting the Case: The Art of Making a Start

3. Prompting Progress: The Art of Making Things Happen

4. Managing Meaning: The Art of Making Sense

Part 2: Front-Line Innovations 5. Under the Radar: Medical Informatics in Japan

6. Relentless Incrementalism: Financial Literacy Training for Newcomers in Canada

7. Join the Club! Alzheimer Cafés in the Netherlands

8. Just a Tool? Implementing the Vulnerability Index in New Orleans

Part 3: Innovations in Governance 9. The Sun Kings: Solar Energy in Germany

10. Change on Steroids: Public Education in New Orleans

11. The Value of Values: Higher Education in Virginia

12. A Window of Opportunity: Institutional Reform in Denmark

Conclusion: Innovating Strategically

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Aging Across the United States

Matching Needs to States' Differing Opportunities and Services

Charles Lockhart and Jean Giles-Sims

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All But Forgotten

Thomas Jefferson and the Development of Public Administration

Study of Thomas Jefferson’s legacy in public administration. Thomas Jefferson’s contributions to the development of administrative thought and practice in the United States have largely been overlooked in American history. His career in public service and his ideas concerning government and constitutional tradition have overshadowed his involvement with public administration. All But Forgotten explores this hidden contribution by investigating Jefferson’s two terms as president and the educational history of the University of Virginia, an institution whose early years were influenced by Jefferson’s theory and practice of administration. Throughout his later years, Jefferson developed a more comprehensive awareness of the effects of the political process on the administration of government, the theoretical and practical value of preserving constitutional tradition, and the constant need to connect contemporary public policy with the types of republican principles found in the Constitution. The end of Jefferson’s career is as important to the historical advancement of administrative theory and practice as the beginning is to political theory and democratic thought.

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America, Germany, and the Future of Europe

Gregory F. Treverton

Gregory Treverton reviews the significant episodes in Europe's history after World War II, emphasizing America's preoccupation with Europe and the decisive effect of U.S. foreign policy on European security and economic arrangements during the postwar years.

Originally published in 1993.

The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

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America Works

Thoughts on an Exceptional U.S. Labor Market

The U.S. labor market is the most laissez faire of any developed nation, with a weak social safety net and little government regulation compared to Europe or Japan. Some economists point to this hands-off approach as the source of America’s low unemployment and high per-capita income. But the stagnant living standards and rising economic insecurity many Americans now face take some of the luster off the U.S. model. In America Works, noted economist Richard Freeman reveals how U.S. policies have created a labor market remarkable both for its dynamism and its disparities. America Works takes readers on a grand tour of America’s exceptional labor market, comparing the economic institutions and performance of the United States to the economies of Europe and other wealthy countries. The U.S. economy has an impressive track record when it comes to job creation and productivity growth, but it isn’t so good at reducing poverty or raising the wages of the average worker. Despite huge gains in productivity, most Americans are hardly better off than they were a generation ago. The median wage is actually lower now than in the early 1970s, and the poverty rate in 2005 was higher than in 1969. So why have the benefits of productivity growth been distributed so unevenly? One reason is that unions have been steadily declining in membership. In Europe, labor laws extend collective bargaining settlements to non-unionized firms. Because wage agreements in America only apply to firms where workers are unionized, American managers have discouraged unionization drives more aggressively. In addition, globalization and immigration have placed growing competitive pressure on American workers. And boards of directors appointed by CEOs have raised executive pay to astronomical levels. Freeman addresses these problems with a variety of proposals designed to maintain the vigor of the U.S. economy while spreading more of its benefits to working Americans. To maintain America’s global competitive edge, Freeman calls for increased R&D spending and financial incentives for students pursuing graduate studies in science and engineering. To improve corporate governance, he advocates licensing individuals who serve on corporate boards. Freeman also makes the case for fostering worker associations outside of the confines of traditional unions and for establishing a federal agency to promote profit-sharing and employee ownership. Assessing the performance of the U.S. job market in light of other developed countries’ recent history highlights the strengths and weaknesses of the free market model. Written with authoritative knowledge and incisive wit, America Works provides a compelling plan for how we can make markets work better for all Americans.

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American Foundations

Roles and Contributions

edited by Helmut K. Anheier and David C. Hammack

Foundations play an essential part in the philanthropic activity that defines so much of American life. No other nation provides its foundations with so much autonomy and freedom of action as does the United States. Liberated both from the daily discipline of the market and from direct control by government, American foundations understandably attract great attention. As David Hammack and Helmut Anheier note in this volume, "Americans have criticized foundations for... their alleged conservatism, liberalism, elitism, radicalism, devotion to religious tradition, hostility to religion —in short, for commitments to causes whose significance can be measured, in part, by the controversies they provoke. Americans have also criticized foundations for ineffectiveness and even foolishness."

Their size alone conveys some sense of the significance of American foundations, whose assets amounted to over $530 billion in 2008 despite a dramatic decline of almost 22 percent in the previous year. And in 2008 foundation grants totaled over $45 billion. But what roles have foundations actually played over time, and what distinctive roles do they fill today? How have they shaped American society, how much difference do they make? What roles are foundations likely to play in the future?

This comprehensive volume, the product of a three-year project supported by the Aspen Institute's program on the Nonprofit Sector and Philanthropy, provides the most thorough effort ever to assess the impact and significance of the nation's large foundations. In it, leading researchers explore how foundations have shaped —or failed to shape —each of the key fields of foundation work.

American Foundations takes the reader on a wide-ranging tour, evaluating foundation efforts in education, scientific and medical research, health care, social welfare, international relations, arts and culture, religion, and social change.

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