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The literature on autonomous public agencies often adopts a top‐down approach, focusing on the means with which those agencies can be steered and controlled. This article opens up the black box of the agencies and zooms in on their CEO's and their perceptions of hierarchical accountability. The article focuses on felt accountability, denoting the manager's (a) expectation to have to explain substantive decisions to a parent department perceived to be (b) legitimate and (c) to have the expertise to evaluate those decisions. We explore felt accountability of agency‐CEO's and its institutional antecedents with a survey in seven countries combining insights from public administration and psychology. Our bottom‐up perspective reveals close connections between de facto control practices rather than formal institutional characteristics and felt accountability of CEO's of agencies. We contend that felt accountability is a crucial cog aligning accountability holders' expectations and behaviors by CEO's.

The newly industrialised and high income economies of East Asia perform remarkably well on a range of health system indicators. We adopt an institutional lens to examine and compare the similarities and differences in health care financing and provision in the paired cases of Singapore, Malaysia, Taiwan and South Korea. This illuminates how, despite seemingly common global, regional and functional demands, reformers have responded through diverse means to different institutional constraints. Moreover, some of these cases illuminate the cognizance of reformers with respect to vulnerabilities in their own health care systems enabling effective, albeit ongoing, management.

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