Alternative Reform Research Articles

Evidence-Based Strategies for Reforming the Medical Curriculum at the National Autonomous University of Honduras: A Systematic Literature Review.

Medical education worldwide has undergone numerous stages of reform. Cultural and financial restraints have decelerated progress in developing countries. Current reforms should focuson creating integrated, competency-based, and student-centered curricula that emphasize patient-centered care. The following review of literature published between 2014 and 2023 on global curricular reforms highlighted key components, challenges, and strategies for implementing or evaluating undergraduate medical programs that prioritize student-centered approaches and competency-based models. This review also compared the current curriculum at the National Autonomous University of Honduras (UNAH) with these international experiences to suggest strategies in order to encourage significant reform. The following review identified 47 articles that provided insights into ideal contexts for curricular reforms, while 15 publications detailed the current state of the UNAH medical curriculum and its potential weaknesses. Additionally, 25 articles discussed specific reforms in other countries, offering valuable results and conclusions for consideration. Drawing from these models and experiences, strategies were proposed for UNAH's curriculum reform, including identifying basic needs, defining project vision, training teaching staff and students, and integrating multidisciplinary teams of experts. Although training all teaching staff abroad may be financially unfeasible, selecting and training key individuals to train others could be a viable alternative. Successful reform requires a comprehensive, periodic, and systematic evaluation. Despite the challenges faced by developing countries, global experiences with alternative reform models offer promising solutions, providing an opportunity for the Faculty of Medical Sciences at UNAH to overcome local limitations and fulfill the primary task of training professionals who are clinically, ethically, and adaptively competent, with a focus on patient-centered and primary care approaches.

Population aging, pensions, informality and labor market frictions in Lebanon. Reforms and policy choices

We evaluate the effects of population aging on the macroeconomic evolution of the Lebanese economy and the financial sustainability of its major pension schemes. We use an OLG model with labor market frictions as in de la Croix et al. (2013). Individuals are differentiated by their origin, age, gender, and education and choose the sector of activity, which implies that the size of the informal sector is endogenous. We assess the long-run implications of population aging and show that the public sector pension scheme is unsustainable. In contrast, the private sector scheme is insufficient to ensure decent living standards for the elderly. Finally, we evaluate the effects of two pension reforms. We first propose a mix of measures that guarantee the sustainability of the public sector scheme. Then, we evaluate the impact of the pension reform introduced in December 2023 and of an alternative reform aiming at increasing the size of the private sector scheme to improve the living standards for the elderly.

A persistent ideal of public services networks amid alternative reform strategies: a study over three decades

ABSTRACT This article analyses how public service networks have evolved over three decades amid alternative reform strategies based on hierarchy or market principles. The longitudinal study of social and employment services in the Netherlands, based on 186 documents and 137 interviews, reveals an intriguing pattern of network rise and fall, repeating over time, with alternative reform strategies being crucial in network dissolution. This study contributes to understanding network evolution through external rather than internal factors. It shows a persistent network ideal, but depicts the ‘old’, traditional governance model as more robust than is usually presented in the public management literature.

Macroeconomic consequences of alternative reforms to the health insurance system in the United States

AbstractThis paper presents a dynamic general equilibrium model designed to examine the macroeconomic effects and welfare implications of alternative reforms to the US health insurance system. Specifically, it scrutinizes the extent to which health care reform can mitigate inefficiencies stemming from market imperfections in the health insurance industry. The model considers a stochastic overlapping generations framework, incorporating heterogeneous agents who are subject to uncertain health shocks. These individuals make optimal decisions regarding labor supply, health insurance, and medical services. Given that the optimal levels of medical consumption and hours worked are endogenous, this setting encapsulates general equilibrium effects. The model is calibrated to US data, and numerical simulations suggest that suitable adjustments to the present health insurance system can broaden coverage and enhance welfare. This improvement is achieved by reducing adverse selection, improving overall health status, and lessening tax distortions on labor supply.

Why Rape Law Revisions should be Consistent with Anderson’s Negotiation Model

In this essay I argue that the current law structure unobjectionably fails to protect women against cases of rape and needs reform. I further maintain that Anderson’s suggestion of ‘negotiation consent’ is the most appropriate line of reform, and I will defend her proposal in the face of potential objections. The current rape law in the UK was implemented in 2003, which revised previous laws firstly defined in the Sexual Offenses Act of 1953. Despite the ostensibly ‘objective’ nature of this law, which will be further examined in this essay, many feminist philosophers have noted the biases within the law which favour male interests. This essay explores the present issues within UK law, as well as our current understandings of what constitutes ‘a reasonable belief of consent’, that fail to protect women in instances of rape. This foundational attitude towards such matters influence performative revision models, such as the No Model and the Yes model, which I consider within this essay. Yet the inadequacies of such approaches, as I demonstrate, mirror some of the current issues with rape law in the UK today; such as the lack of recognition of men’s frequent inability to interpret women’s nonverbal behaviour and disregard for instances where one person changes their mind.
 Furthermore, I advocate for Anderson’s proposal of the negotiation model as an alternative reform of the law as well as society’s attitude towards sex and how consent can be clearly obtained. This model, when legally applied, will not only legally protect women in cases of rape, but eventually protect them from the present societal norms that perpetuate the imminent risk of rape and sexual exploitation.
 Through making the act of negotiation a legal requirement, I maintain that there would be a ‘ripple effect’ throughout society that would, eventually, lead to a change in public expectations of men and women.
 Anderson’s emphasis on either party being able to initiate the negotiation establishes a much more open-minded attitude towards gender roles and expectations of individuals based on their gender. This is the greatest strength of Anderson’s argument, as this equality-driven initiative would eventually seep into society’s wider expectations of individuals when initiating sex, and create a world where understanding what the other person is anticipating in a sexual situation is the norm.

Principals, Paradigms, and Possibilities: STEAM Education Reform and the Centering of Black Life

This analysis explores how middle school principals in the southern U.S. made sense of a multiyear STEAM education reform. Principals’ retrospective and prospective accounts, conveyed in interviews ( n = 9), are dominated by neoliberal paradigms and seldom reflect Black families’ everyday cultural life as a resource for learning. We conclude that without redirection, the reform stands to continue divesting from Black life in schools. In an exercise in Black specificity, we propose Black Futurity STEAM as an alternative reform imaginary that centers the creative impulses and capacities of Black children and cultural life in disciplinary learning.

RESOLUTION PROFESSIONAL: ROLE, APPOINTMENT AND ITS IMPACT ON THE COMPANY'S LIQUIDATION

The most significant alternative reform in the Indian legal system is the IBC. It is because the Insolvency and Bankruptcy Code, 2016 (IBC) is giving India a new identity and economic legitimacy on a global scale while simultaneously emphasizing its importance in the legal sphere. India's bankruptcy law, the Insolvency and Bankruptcy Code of 2016, aims to unify the existing system by combining insolvency and bankruptcy under a single body of law. The study is of a descriptive kind. Moreover, the article also discusses the function of the resolution specialist and how it contributes to the liquidation process.

The case for approval voting

AbstractCitizens in many US states and cities in recent years have pushed for various reforms of voting methods. This raises the important question of which reform will best meet both normative and practical goals of representative democracy. While also evaluating criticisms of it, we make the case in this article that approval voting is the simplest actionable response. More specifically, we argue that approval voting offers distinct advantages, not only relative to the status quo of plurality voting, but also relative to alternative reforms. By giving voters the ability to support multiple candidates equally, approval voting grants true agency to the electorate to select strong winners among a candidate pool that is more competitive, diverse, and responsive to what voters want. As a low-cost yet high-impact electoral reform, the implementation of approval voting can create meaningful and lasting improvements in the quality of representation and policies.

Assessing the New Municipalism Reform of Advisory Councils: The Cases of Madrid and Barcelona (2015–2019)

New Municipalism governments in Madrid and Barcelona (2015 − 2019) promoted a new agenda which included participatory budgeting, e-initiatives, and randomly selected forums. Both cities implemented deep modifications in their Advisory Councils’ (AC) systems while the ‘New Municipalism movement’ (radical-left candidacies) was in government for first time. In this article we reflect on how these municipal administrations faced the different strategies for reform across their ecosystem of ACs. For this purpose, our analysis relies on six dimensions (drivers, inclusiveness, deliberation, communication, policy-making capacity and connectedness) which are identified in the literature and are empirically applied through a comparative case study (thirty-one interviews). Despite the common agenda, the cases show dissimilarities which are connected to alternative reform strategies: one case was characterized by experimentation (Madrid), the other by slight improvement (Barcelona). Path dependency contributes to understanding these alternative logics, even when a common agenda was at play.

Agriculturist V.G. Venzher in the Search of Reforming the Soviet Union

On the anniversary of the centenary of the formation of the Soviet Union, we naturally remember the name and ideas of one of the most brilliant Soviet agricultural economists, who made a huge practical and theoretical contribution to attempts to reform not only Soviet agriculture but also Soviet society as a whole. Vladimir Grigoryevich Venzher (1899–1990) was an agriculturist and economist, who primarily became widely known for his correspondence with Stalin in the early 1950s about the possibilities of reforms in the collective farm system of the Soviet Union.At the same time, the fact that his personality was much broader and deeper than his professional incarnation as an agrarian economist. Venzher, of course, was also an original and deep social thinker, partly Marxist and partly populist-cooperative, who repeatedly proposed to the Soviet leadership and then in relation to the Kosygin and Gorbachev reforms a number of comprehensive alternative reforms aimed at shaping the sustainable development of the Soviet Union and Russia based primarily on the required agrarian reforms.1 To prove and develop this statement, this article examines several key fragments of the political economy and social and philosophical heritage of Venzher in the 1960s–1980s, his letters to the Central Committee of the CPSU, and some of his scientific monographs, which have not yet attracted much attention from researchers.

Coping with demographic change: macroeconomic performance and welfare inequality effects of public pension reform

AbstractThis paper evaluates alternative reforms of the public pension system in an overlapping generations model for an open economy facing demographic change. We make progress compared to existing literature on pension reform by modelling individuals with heterogeneous innate ability and endogenous human capital, and by putting (the reduction of) welfare inequality effects of reform at the centre. Frequently adopted reforms such as an increase of the normal retirement age or a decrease of the pension benefit can guarantee financial sustainability, but they fail when the objective is also to avoid intergenerational or intragenerational welfare inequality. Our results prefer a reform which combines an increase of the retirement age with an intelligent linkage between the pension benefit and earlier labour earnings. First, this design conditions pension benefits on past individual labour income, with a high weight on labour income earned when older and a low weight on labour income earned when young. Second, this linkage is complemented by a strong rise in the benefit replacement rate for low ability individuals (and a reduction for high ability individuals).

Impacts of agricultural taxation in Sub‐Saharan Africa: Insights from agricultural produce cess in Tanzania

AbstractThis article analyses the economic impacts of agricultural produce cess in Tanzania and compares its effectiveness with alternative reform options relying on its removal or reduction. Produce cess is one of the common forms of agricultural taxation in Sub‐Saharan Africa. This analysis is performed using the farm‐household model FSSIM‐Dev, which is applied to a country representative sample of 3134 individual farm households taken from the 2012/2013 Tanzania National Panel Survey. Simulations show that the current produce cess is rather high and its removal or reduction would increase production intensity and boost farm income, ranging between +2% and +21% depending on options and regions. These positive impacts are driven by land productivity improvement rather than area reallocation. The largest impacts are experienced in northern and western highlands. Large farms and farms specialized in cash crops tend to gain more from the abolishment or reduction of produce cess. The increase in both production and income is, however, not sufficient to significantly reduce rural poverty and improve nutrition security. Finally, results show that a uniform cess rate of 1% for all crops seems to be the most appropriate policy option. It gives the best trade‐off between government revenue loss and farmers’ economic gain.

Improving paratransit service: Lessons from transport management companies in Nairobi, Kenya and their transferability

Paratransit is the dominant form of public transport throughout cities of the Global South. Many of these cities recognize the negative characteristics of paratransit services stemming from competition in the market and have attempted to undertake reforms aimed at addressing these negative aspects. Comprehensive replacement of paratransit with bus rapid transit systems is a common reform approach, but the transition from atomized paratransit operators to formalized vehicle operating companies has proven more difficult and time-consuming than anticipated. In addition, high operational costs for BRT systems, especially when compared to paratransit services that impose no direct operational cost to government, are unsustainable burdens on limited budgets. Acknowledging these challenges, the City of Cape Town, South Africa has reevaluated this comprehensive replacement approach and recognized a continued role for paratransit in a hybrid public transport network. There remains the question of alternative approaches for improving paratransit service quality; the case of transport management companies (TMCs) in Nairobi provide an interesting model. The TMC structure improves passenger service quality by employing drivers on a salaried basis, managing operations collectively, and monitoring service delivery while maintaining profitable (subsidy-free) service. Therefore, this model appears to be a viable alternative reform approach for Cape Town and other cities in similar situations. This paper details the TMC structure, benefits for stakeholders, and discusses its potential as an alternative public transport reform path.

Statecraft and incremental change: Explaining the success of pension reforms in the United Kingdom

How were comprehensive pension reforms in the UK successfully developed, enacted and implemented from 2002 to 2015, despite changes in government composition and the financial crisis? Why were they not subject to policy conflict, electoral competition and policy reversal? Drawing on actor-centred historical institutionalism and thirty interviews with key actors, we demonstrate the critical role played by a limited number of politicians and policy entrepreneurs and their ideas and agency. Institutional continuity with the Beveridgean policy legacies of the pension system and the United Kingdom’s `growth regime’ enabled a coalition space to open up for policy agreement. between the government and Opposition parties, and for partisan electoral competition over the reforms to be `bracketed’. The incremental and interlocking nature of the reform package reduced interest group opposition and enabled a centralisation of decision-making power. A long-term timeframe for reform cemented the formation of an elite coalition and buttressed political control. Cross-party support for the reform package, coupled with judicious phasing of the implementation of auto-enrolment and fiscal reforms, enabled it to withstand the impact of the financial crisis and the austerity that followed it, and to minimise opposition among the critical electoral constituency of older voters. The dominance of the reform process by political actors and policy entrepreneurs in the UK nonetheless came at a price, as institutional continuity and incrementalism foreclosed alternative reforms. We demonstrate the importance of political statecraft and policy entrepreneurship in the UK pensions’ reform process, but within boundaries set by its institutional context.

Competition reform and household welfare: A microsimulation analysis of the telecommunication sector in Ethiopia

This paper presents a novel simulation method for estimating the likely welfare effects of policy reforms aimed at increasing competition in strategic economic sectors such as mobile phone services. The proposed method relies on a partial equilibrium simulation approach and estimates the welfare impacts on current consumers and the potential welfare effects among new consumers brought into the market by changes in prices due to competition. This approach is applied to the information and communication technology (ICT) sector in Ethiopia, one of the three countries in the world with a monopoly in the market for mobile phone services. Based on household budget survey data for 2015/16 and departing from a baseline reform scenario that dilutes the market share of the state-owned monopoly to 45 percent, the simulation model estimates a 25.3 percent reduction in the price of mobile services and an increase in 5.7 million new users of mobile services. The predicted drop in prices and increased users would generate a combined relative welfare gain of 1.18 percent (1.09 percent among current users and 0.09 percent among new users), that could be translated into a 0.31 percentage point decline in the national poverty rate and equivalent to lifting about 275,000 people out of poverty. Alternative reform scenarios that dilute the market share of the monopoly to 75 percent and to 30 percent are expected to reduce poverty rate in 0.13 and 0.52 percentage points, respectively. The method proposed in this study represents a useful tool for promoting competition reforms in developing countries, particularly in sectors known for excluding significant segments of the population because of high consumer prices.

Captive power, market access and macroeconomic performance: Reforming the Bangladesh electricity sector

Integrating the captive capacity with the on-grid supply has been advocated as a way to improve resource utilization in the electricity market in developing and emerging countries. Despite many countries granting Captive Power Plants (CPPs) access to the grid, integration may still be hindered by other barriers to entry. In Bangladesh, CPPs are required to sell their electricity surplus, but there is no evidence of trading with the national grid, mostly due to high connectivity costs. In this paper we develop and estimate a fit-for-purpose Dynamic Stochastic General Equilibrium (DSGE) model to examine the effects of the Bangladeshi CPPs connecting to the national grid and selling their surplus at regulated prices. The model parameters are set through a combination of calibration and Bayesian estimation. We find that if CPPs are connected to the national grid, steady-state industrial output, GDP, and household consumption decrease due to pre-existing energy price distortions. These results support the second-best theory, which implies that merely connecting the CPPs to the national grid without firstly removing market distortions can lead to economically inefficient outcomes. Instead, government should first consider alternative reforms such as phasing out subsidized tariffs and enabling a competitive market environment.

Learning From Failures: Lessons From Unsuccessful Grading Reform Initiatives

This article describes accounts of grading reform initiatives that while well-intentioned, met with staunch opposition and eventually were abandoned. The implementation strategies employed by the leaders of these reform initiative are explored, along with reasons these strategies failed to result in meaningful and enduring change. Alternative grading reform strategies with supporting evidence are offered, justification for their use explained, and new directions for grading reform initiatives recommended.

A Quantitative Assessment of the Net Wealth Tax: The Spanish Experience

Abstract There is growing debate, both social and academic, about the possibility of levying an annual net wealth tax. Until a few years ago, such a proposal appeared difficult to both implement and control, but recent technological innovations, which could greatly facilitate the periodic valuation of wealth, combined with improvements in international tax information sharing could make a “modern wealth tax” possible. Nonetheless, a number of challenges regarding its design still need to be addressed. Taking advantage of the Spanish experience—the only EU country to levy a wealth tax—we undertake a quantitative analysis of various key legal elements of the current tax (exemptions and the common income and wealth tax ceiling) by means of a tax simulator we have developed; we also analyze its redistributive power. Our results show that the family business exemption and the common ceilings are highly regressive. We also assess the effectiveness of alternative reforms with more comprehensive tax bases (JEL codes: H24, H23, and D31).

Equivalence in the area of financial services: An effective instrument to protect EU financial stability in global capital markets?

The article investigates whether the main EU regulatory mechanism for managing cross-border trade in financial services with third countries, the EU equivalence regime, is compatible with the post-financial crisis objective of protecting financial stability. Equivalence allows third-country financial firms to operate in the internal market on the basis of their home country regulation if this is equivalent to EU law. There are three different procedural safeguards to avoid financial stability risks: a) ex ante assessment of third countries’ regulation to ensure regulatory compatibility between the EU and the third country; b) ex post withdrawal of market access if cross-border liberalization triggers a “race to the bottom”; and c) direct supervision of systemic third-country entities to prevent them from becoming vectors of cross-border systemic risk. The article argues that those safeguards are ineffective in protecting the internal market from external risks. It proposes two alternative reforms. First, the EU could replace equivalence with a system of substituted compliance, following the US model where foreign financial firms must register with local authorities and follow host country regulation. Alternatively, the EU could reinforce the assessment, withdrawal, and supervisory procedure by harmonizing the current patchwork of different

Is There a Leak in the OECD's Global Minimum Tax Proposals (GLOBE, Pillar Two)?

There might be a leak in the OECD’s global minimum tax proposals (GLOBE; Pillar Two). To address the remaining challenges of base erosion and profit shifting (BEPS) by large multinational enterprises the OECD envisages a global minimum level of company taxation and top-up taxation by countries up to that level where other countries do not adhere to the new standard. The objective is to reach political consensus mid this year within the Inclusive Framework, a tax policy discussion platform of the OECD uniting around 140 countries. A blueprint on the system’s technical design is currently being debated. If put in place as now devised the Pillar Two system may be prone to be gamed. Parties having an interest in this would be able to raise the minimum level at their discretion - without actually paying more tax - to accordingly circumvent the application of the top-up taxation mechanisms. The key lies in the strategic use of differences between tax accounting and commercial accounting, particularly those in relation to the qualification of financial instruments as debt or equity. Underneath lies the choice to base the Pillar Two system on transfer pricing and single-entity financials. If left unaddressed a new world of tax planning opportunities would likely emerge. Please read further below on how the planning would work, together with references to some alternative reform options to address the challenges raised in international company taxation.