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AbstractThe "Rose Garden strategy" has traditionally been understood to refer to presidential activity within Washington, DC, where incumbents drape themselves in the grandeur and symbolism associated with the office of the presidency in an attempt to bolster their public image. This article argues that our understanding of the Rose Garden strategy should be conceptualized more broadly to encompass activities beyond Washington, DC. It does so by examining the role of overseas presidential travel in incumbents' reelection strategies, taking Ronald Reagan's 1984 European tour as a case study. Reconceptualizing our understanding of the Rose Garden strategy offers us a more nuanced understanding of the relationship between the president, the public, and the press by demonstrating the benefits and limitations of positive press coverage in relation to public opinion of the president.

This paper explores the changing role of government involvement in health care financing policy outside the United States. It provides a review of the economics literature in this area to understand the implications of recent policy changes on efficiency, costs and quality. Our review reveals that there has been some convergence in policies adopted across countries to improve financing incentives and encourage efficient use of health services. In the case of risk pooling, all countries with competing pools experience similar difficulties with selection and are adopting more sophisticated forms of risk adjustment. In the case of hospital competition, the key drivers of success appear to be what is competed on and measurable rather than whether the system is public or private. In the case of both the success of performance-related pay forproviders and issues resulting from wait times, evidence differs both within and across jurisdictions. However, the evidence does suggest that some governments have effectively reduced wait times when they have chosen explicitly to focus on achieving this goal. Many countries are exploring new ways of generating revenues for health care to enable them to cope with significant cost growth. However, there is little evidence to suggest that collection mechanisms alone are effective in managing the costor quality of care.

This paper explores the changing role of government involvement in health care financing policy outside the United States. It provides a review of the economics literature in this area to understand the implications of recent policy changes on efficiency, costs and quality. Our review reveals that there has been some convergence in policies adopted across countries to improve financing incentives and encourage efficient use of health services. In the case of risk pooling, all countries with competing pools experience similar difficulties with selection and are adopting more sophisticated forms of risk adjustment. In the case of hospital competition, the key drivers of success appear to be what is competed on and measurable rather than whether the system is public or private. In the case of both the success of performance-related pay forproviders and issues resulting from wait times, evidence differs both within and across jurisdictions. However, the evidence does suggest that some governments have effectively reduced wait times when they have chosen explicitly to focus on achieving this goal. Many countries are exploring new ways of generating revenues for health care to enable them to cope with significant cost growth. However, there is little evidence to suggest that collection mechanisms alone are effective in managing the costor quality of care.

Several European countries have considered introducing choice of public or private health insurance - usually by allowing people to 'opt out' of the statutory scheme - under the assumption that enhancing consumer choice and stimulating competition between insurers will be beneficial. This article examines the impact of opting out on equity and efficiency in European health systems. Focusing on Germany and the Netherlands - the only European countries where this type of choice has been available to significant population groups for a prolonged period (from 1970 to the present day in Germany, and from 1941 to 1986 in the Netherlands) - the analysis suggests that current policy debates may overstate the potential benefits of opting out. Due to market failures in health insurance and differences in the regulatory frameworks governing public and private insurers, choice of public or private coverage creates strong incentives for private insurers to select risks and leads to risk segmentation, thereby breaching equity in funding health care, heightening the financial risk borne by public insurers and lowering incentives for private insurers to operate efficiently. Measures can be taken to correct these negative effects, but some forms of regulation may be politically and technically difficult to implement.

Can private health insurance fill gaps in publicly financed coverage? Does it enhance access to health care or improve efficiency in health service delivery? Will it provide fiscal relief for governments struggling to raise public revenue for health? This book examines the successes, failures and challenges of private health insurance globally through country case studies written by leading national experts. Each case study considers the role of history and politics in shaping private health insurance and determining its impact on health system performance. Despite great diversity in the size and functioning of markets for private health insurance, the book identifies clear patterns across countries, drawing out valuable lessons for policymakers while showing how history and politics have proved a persistent barrier to effective public policy. This title is also available as Open Access on Cambridge Core.

Hager and Brudney (2004, 2005) developed a Net Benefits Index (NBI) to measure the performance of volunteer programmes. Their benchmarking tool scores an organisation's performance against six specific benefits and eight recognised challenges that organisations face in recruiting and managing volunteers. This article extends the NBI by demonstrating its use as an internal programme evaluation tool within two health non-profit organisations. By surveying all staff and volunteers (rather than relying on the organisational response from a single individual), the tool provides valuable insights into volunteer and staff attitudes about the volunteer programme. In addition to critiquing the NBI, this article highlights reasons for divergent scores between volunteers and staff and the improvements that can be made to a volunteer programme's effectiveness as a result of measurement.