How institutional legacies constrain reform during a favourable policy window: COVID-19 and the healthcare workforce shortage
研究了瑞士在新冠疫情后应对医疗劳动力短缺的改革中，自由化和性别不平等的制度遗产如何制约改革，即使处于有利的政策窗口期，改革仍难以偏离既有路径。
This article explores how institutional legacies surrounding liberalisation and gender (in)equality constrain health workforce reform during a favourable policy window: the COVID-19 crisis. To do this, it uses the case of the reforms addressing the shortage of healthcare workers in Switzerland in the aftermath of the COVID-19 pandemic. The results expose the inertia embedded in existing institutional frameworks, even after the adoption of path-departing reforms, highlighting the challenge of deviating from established trajectories within an open policy window. The research uncovers how gender legacies, coupled with a liberalised healthcare system under cost pressure, maintain a status quo in direct state intervention outside the funding system, while allowing more groundbreaking reforms in other settings such as education. In essence, the article demonstrates that the design of policies adopted in opened policy windows, such as crisis situations, remains anchored in institutional frameworks, only partially deviating from existing paradigms when the policy setting does not clash with the healthcare financing schemes. In this way, this article makes a timely and intriguing contribution to our understanding of how institutional contexts influence policy design.