2005 institutional theories. the role of political institutions lecture 7 health politics ana rico...
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2005Institutional theories. The role of political institutions
Lecture 7
Health Politics
Ana Rico
2005
The old institutionalism
I. Research question
Which is the impact of political institutions and the social structure on democratic politics and policy change?
II. Main concepts - definitions
Majority and consensus democracies, plurality and proportional electoral systems, presidentialism, parliamentarism, federalism
III. Thesis and arguments
Institutions which disperse power across political and sociopol. actors are more democratic (responsive) & equally effective
III. Anti-thesis: the new institutionalism
Concentrated state power needed for effective policy change
IV. Aplications – evidence
Political institutions in Western Europe (Liphart, 1984; 1999)
VI. Policy implications
Power concentration is good for passing controversial policy, but can have high political and implementation costs
2005
SOCIAL PRESSURES OLD INSTITUTIONALISM Formal political institutions
SOCIAL ACTORS (IGs: dependent on
social pressures)POLITICAL ACTORS (STATE: independent
of social pressures)
SOCIOP. ACTORS (STATE-SOCIETY: interdependent) NEW INSTITUTIONALISM
(state institutions & state/PPs/IGs’ organization)
POWER-CENTRED THEORIES (interactions among collective actors & social structure)
RATIONAL CHOICE (interactions among individuals
ACTOR-CENTERED INSTITUTIONALISM (interactions among institutions & elites)
1950s/60s: SOCIAL CONTEXT
1970s/1980s: ACTOR-CENTRED
1990s: INSTITUT-IONALISM (+state-society)
2000s: ACTION THEORIES
SOCIAL & POLITICAL THEORIES
L3
L5L2, L4
L6
L7
L9L4, L9
L7
L7, L9
2005
SOCIAL CONTEXT: The state as a ‘transmission belt’ of social pressures
STATE-CENTRIC: The state as a unitary, independent actor with formal monopoly of (residual) power over policy-making
STATE-SOCIETY: The state as a set of political representatives and policy experts with preferences and action partly independent, and partly determined by a wide range of social actors’ pressures
INSTITUTIONALIST: The state as a set of political institutions; or as a set of elites with preferences and actions mainly determined by institutions
ACTION: As a set of political organizations which respond to context, sociopolitical actors and institutions; and which compete and cooperate (=interact) to make policy
CONCEPTS (4): The state
2005
ANTECEDENTS (3)
Old political institutionalism (Lijphart)
• Formal centralization of decision-making power makes political regimes, states and organizations more capable & more efficient
• State powers are more centralized when:
Democratic Institutions: Majoritarian (vs proportional) electoral systems; Unitary (vs federal) states; Executive dominance (+/- = parliamentarism vs. presidentialism);
Sociopolitical organizations: Biparty/multiparty systems, majority vs. coalition) government; Corporatism (vs pluralism); Party discipline and centralized organization
Social groups: Single (=class) vs multiple cleavages in the soc. struct. seen as causes of institutions
Single/multiple cleavages biparty/multiparty system single party/coalition gov. centralized democratic institutions
2005
Types of democratic institutions in the EU
The old institutionalism
MAJORITARIAN CONSENSUS
Unidimensional party systems Multidimensional party systems
Two party systems Multiparty systems
Majority(/plurality) elections Proportional elections
Concentration of executive power:
majority government
Executive power-sharing: coalition
governements, corporatism
Executive dominance over parliament
(Presidentialism)
Division of powers (Parliamentarism)
Unicameralism or asymm. bicameralism Balanced bicameralism
Unitary and centralized Federal and devolved
Unwritten constitution Written constitution and protection of
minorities
Representative democracy, pluralism Forms of direct (corporatist) democracy
Lijphart, 1984 Later US research shows that Presidentialisms disperses power more
2005
Other arguments and counterarguments (1)
1. LIJPHART’S THESIS
• The interplay between social structure, political institutions and sociopolitical
groups determines policy
• Institutions which concentrate power can be more effective, but are less
democratic costs in terms of political support & implementation gaps
• Institutions which disperse power across actors are more democratic
(minorities´representation, direct political participation), and, under some
conditions (cooperation, consensus building), can be equally effective
(minorities’ protection, economic growth, income inequality)
2. CRITICISMS (anti-thesis)
New institutionalism• Institutions which concentrate state and socioP power are needed for state
capacity/autonomy + effective policy changeActor-centred institutionalism• Institutions which disperse state power allow more points of acess (veto
points) for IGs to block policy
The old institutionalism
2005
Arguments and counterarguments (2)
1. LIJPHART’S THESIS (2)
Types of political institutions and degree of concentration of power
Majoritarian vs. consensus institutions: Functional division of power –DoP- among state organizations and political parties
Unitary vs. federal institutions Territorial DoP – between federal/central and state/local governments)
[Corporatist vs. Pluralist: DoP between state and social groups)]
2. CRITICISMS
NOTE: Later institutionalists socioP institutions such as party discipline,
or minor constitutional reforms in EU 1950s allowing the Executive to
pass legislation by decree, are critical too to promote power
concentration
The old institutionalism
2005
The electoral system (translates social support/votes into % of state power)
A. Proportionality = votes/parliam. seats ( access to govern. & parliament) Main dimensions Maj Prop Maj Prop
Electoral formula < % Prop > Electoral thresholds > <
District magnitude Small Big Ballot structure 1/2 rounds
Supplementary seats No Yes
C. The social and socioP power structure: Cleavages & pol. parties
The old institutionalism
NON-PLURAL (2-3
parties, 1 cleavage)
SEMI-PLURAL (3-5
parties, 1-2 cleav.
PLURAL (> 5
parties, 2-3 cleav.)
Relig./linguistic
homogeinity
HIGH
UK, Ireland
New Zealand
Scandinavian
Finland
France
Italy
Austria
Israel
Luxemburg
Religious/ling.
heterogeinity
LOW
Australia Germany
Canada
United States
Belgium
Netherland
SwitzerlandLijphart, 1984
2005
PRESIDENTIALISM:
President elected by
citizens, strong Parliament
PARLIAMENTARISM
Prime Minister strong,
elected by Parliament
MAJORITARIAN
(plurality)
United States
Philippines
Puerto Rico
Ex-Soviet
United Kingdom
Canada
Australia
New Zealand
Asia
Africa
PROPORTIONAL France
Switzerland
South America
Most Western Europe
Th
e e
lect
ora
l sys
tem
The DoP between Executive & Parliament
Lijphart, 1994
2005
Modern institutionalist theory
I. Research questions Are institutions the main cause of policy? Do they determine actors’ behaviour?
II. Main concepts - definitions Types of political institutions; path dependence and institutional inertia.
III. Thesis and arguments New institutionalism: (1) Institutions determine actors’ preferences, resources and
strategies, and therefore reinforce and reproduce the status quo
Actor-centred institutionalism (infl. by ECO): (2) Formal political institutions modify (weaken or strengthen) the degree of autonomy of state actors from IGs
IV. Aplications – evidence Explaining the emergence of different health care systems
V. Policy implications (1) Institutions do not change, hence big policy turns are unlikely;(2) Changing formal
constitutional rules increases the likelihood of state-led policy change,
VI. Criticisms Institutions can be changed through political action and policy reform; lack of change is
due to entrenched interest groups and/or reluctant citizens
2005
a. Demands and supportsb. Access to the political systemc. Decision-making
d. Institutional changee. Impact of policyf. Distribution of costs and benefits
State actors:•STATE-, POL. PARTs (IGs)
Policy change
INPUTS
Outcomes
THE POLITICAL SYSTEM
POLICY (SUB-) SYSTEM
a c
d e
b
OUTPUTS
Outputs
POLICYPOLITICSPOLITY
f
HC SYSTEM
Formal & informal institutions SOCIAL CONTEXT
Institutions:• Const. (interorg.)• Organiz. Struct.
Interactions:• Coalitions/competit.• Leadership/strategy
Sociopol. actors:
• IGs, Prof Ass., Unions• Citizens, Mass media• Political parties
CONSTITUTION
CULTURE
* Org.Struct.
* Subcultures /pol.identities
* Ideologies * Ideas
Social organiz. • Associations • Churches• Firms
Social groups - Communities- Ethnia, gender- Social classes
* Policy paradigms/ legacies
2005
Institutions (including public policies, organizations) block new policy because of their strong resistance to change (inertia) once settled (path dependence)
Institutional inertia/path dependence is in turn due to:
A. Technical/cognitive causes (decreasing returns = economies of scale/scope, learning costs)
ECO + some POL. Sci. (eg Pierson 1998, Wilsford, 1995)
B. Normative causes (cognitive rules are given normative meaning through the processes of socialization carried out to guarantee the compliance of individuals to rules; once linked to values, rules become difficult to change)
Anthropology, Sociology, ORG THEORY, Policy Anallisys
Social embebbedness (Evans)
Policy change happens only as a result of an external shock which opens a policy window for reform
The new institutionalism
20052004
1. Political institutions which allow f or the dispersion of power generate multiple points of access of interest groups through which they can veto state policies
2. Under dispersed f ormal political power, the chances of policy change (eg WSexpansion) are low I mmergut 1992
3. NOTE: Here Presidentialism considered to disperse rather than concentrate power (evolution f rom Lijphart based on legislation by decree & party discipline)
Corporatism (EU)Pluralist (USA, UK)
Party discipline (EU, Canada)No party discipline (USA)
Majority electoral system (US, UK) PR electoral system (EU)
Unitary (UK, Sweden, France)Federal (US, Switz., Canada)
Strong executive Weak parliament and courts (EU, Fra 2)
Weak executive (US, Switz., Fra 1)Strong parliament and courts
CONCENTRATEDDISPERSED
Political institutions
Socio-political institutions
ACTOR-CENTRED INSTITUTIONALISM
Immergut, 1992
2005
DETERMINANTS SWEDEN FRANCE SWITZERLAND
Policy idea + + +
Government’s support
Interest groups - - -
Left vote & unions + - -
Territ. DoP (‘state capacity’) Unit. Dev. (-) Unit. Centr. (+) Federal (--)
Veto points/(DoP E/P/C) Few (+) * 1st : Multiple (-)
* 2nd : Few (+)
Multiple (--)
Party system (& discipline)* Influenced by electoral system
Concentr (+) Dispersed (-) Highly disp. (--)
POLICY CHANGE NHS (++) SHI (+)
* 1st : -
* 2nd : +
PI (-)
Determinants of National Health Insurance systems
Immergut, 1992
Actor-centred institutionalism
2005
a. Demands and supportsb. Access to the political systemc. Decision-making
d. Institutional changee. Impact of policyf. Distribution of costs and benefits
Sociopol. actors: • NEW SOCIAL MOV.• MASS MEDIA• IG & PROF ASS• POLITCAL PARTIES
Institutional framework
Policy actors:•STATE ACTORS• IG & PROF ASS• POLITCAL PARTIES
Interactions
Policy change
INPUTS
Outcomes
THE POLITICAL SYSTEM
POLICY CONTEXT
ac
d e
b
OUTPUTS
Outputs
POLICYPOLITICSPOLITY
f
HC services
Implemen-tation
Social organiz.• ASSOCIATIONS • CHURCHES• FIRMS
Social groups• COMMUNITIES• ETHNIA, GENDER• SOCIAL CLASSES
Veto pointsSOCIAL CONTEXT
2005
(State) actors and political parties are the main determinant of policy
Institutions increase or decrease their opportunities to influence policy
EVIDENCE: Canada (NHI) vs the US (no NHI) in the 1960s
In the US as in Canada, the main advocate of NHI were small socialdemocratic parties territorially concentrated
In the US as in Canada, the majority of citizens strongly supported NHI in these states/provinces
In Canada, due to open political acess & strong federalism in HC, a tiny socialdemocratic party ruling in one province introduces NHI, demonstrating that can work with good effects outside Europe this helps them convince the reluctant democratic party & public opinion to support it at national level
In the US, weak federalism impedes pro-WS minority parties to govern no demonstration effects possible
Actor-centred institutionalism
Maioni, 1997
2005
CAUSES OF NHI: CANADA vs USA
VARIABLES CANADA 1960S: NHI USA 1960s: NO NHI
CONTEXT.
Social values, culture Individualism Individualism
INSTITUTIONS (RULES)
1. Executive dominance
2. Federalism
3. Party discipline
Medium/weak
Strong
Yes
Weak
Weak
No
ACTORS (PLAYERS)
1. State authorities
2. Pro-WS Pol. Parties + IGs
Weak
Access to governm.
Weak
No access
PAST POLICY
1. Past WS policies in HC (a
cause of state auton. & capacity)
Underdeveloped Underdeveloped
Maioni, 1997
2005
FISCAL FED.
60s 70s 80s 90s 00s
POLITICAL DEVOLUTION
NORDIC COUNTRIES
ITALY /SPAIN
FISCAL FED.
CENTRAL COORD.
FEDERALISM IN EU HC
POL. DEVOLUTION
POL. DEV.?UK / GREECE / (PORTUGAL)
CENTR??
2005
FEDERALISM & impact of DoPower
CENTRAL SHARED LOCAL
RESPONSIVENESS Interests represented Decision costs
- -
++ ++
+
+ ? ACCOUNTABILITY Visibility (citizens) Control (central state)
++ ++
- +
-- ? - ?
Political OUTCOMES (for democratic representation)
2005
New institutionalism, path sependence:
Institutions do not change, hence once they are established big policy turns are unlikely
Historical determinism: countries are prisioners of history (and individuals of their early socialization experiences/the prevailing social norms)
Actor-centred institutionalism (old-institutionalism): debate on
Immergut: Changing formal political institutions towards further concentration of power increases the likelihood of policy change, even if powerful opposed interests
Maioni (with Lijphart): Institutions which disperse power increase access of minority political parties in government and hence the likelihood of policy change
POLICY IMPLICATIONS
2005
Old-institutionalism
Presidentialism implies dispersion of power across state organizations (President and Parliament), while Parliamentarism implies dispersion of power across political parties and Igs
New institutionalism, path dependence: Political actors can modify some of the rules of the game or ignore them
Part of the causes included under ´institutions´ are rather culture, actors or past policy + state performance
Low explanatory power: it only explains policy inmobility or small changes in policy instrument, but not big policy reforms or instances of path reversal
Actor-centred institutionalism, : Veto points do not only allow private IGs (anti-WS, capture) to block policy, but also public (eg
citizens’) IGs to support government policies (pro-WS, democratic participation).
The degree of concentration of political power not only depends on formal institutions, but also on the social structure (eg active cleavages) and actors’ strategies (coalitions, internal cohesion collective action socioP power resources)
CRITICISMS