Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-26T07:18:24.307Z Has data issue: false hasContentIssue false
  • English
  • Français

Strategic Institutional Design: Two Case Studies of Non-Majoritarian Agencies in Health Care Priority-Setting

Published online by Cambridge University Press:  24 November 2014

Claudia Landwehr  and
Katharina Böhm
Get access Rights & Permissions [Opens in a new window]

Abstract

Governments’ decisions to delegate policy decisions to non-majoritarian agencies have been both criticized as attempts at blame avoidance or depoliticization and defended as enhancing the rationality and credibility of decisions. This article focuses not on the decision to delegate, but on the decisions of how and to whom to delegate. We argue that strategic motives are relevant not only in the decision to delegate, but equally, and perhaps more importantly, in the selection of the institutional properties of these non-majoritarian agencies. We present two case studies of health care priority-setting, in England and Germany, to illustrate how governments proceed strategically in institutional design choices and how their decisions affect outcomes.

Type
Articles
Information
Government and Opposition , Volume 51 , Issue 4 , October 2016 , pp. 632 - 660
Copyright
Copyright © The Author(s). Published by Government and Opposition Limited and Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Claudia Landwehr is Professor of Public Policy at Johannes-Gutenberg-University, Mainz. Contact email: [email protected].

Katharina Böhm is a junior research fellow in the Department of Political Science at Johannes-Gutenberg-University, Mainz. Contact email: [email protected].

References

Bertelli, A. (2006), ‘The Role of Political Ideology in the Structural Design of New Governance Agencies’, Public Administration Review, 66(4): 583–595.Google Scholar
Böhm, K., Landwehr, C. and Steiner, N. (2014), ‘What Explains “Generosity” in the Public Financing of High-tech Drugs?’, Journal of European Social Policy, 24(1): 39–55.Google Scholar
Crouch, C. (2004), Post-Democracy (Cambridge: Polity Press).Google Scholar
Elgie, R. (2006), ‘Why do Governments Delegate Authority to Quasi-Autonomous Agencies? The Case of Independent Administrative Agencies in France’, Governance, 19(2): 207–227.Google Scholar
Flinders, M. (2009), ‘Theory and Method in the Study of Delegation: Three Dominant Traditions’, Public Administration, 87(4): 955–971.Google Scholar
Flinders, M. and Buller, J. (2006), ‘Depoliticisation: Principles, Tactics and Tools’, British Politics, 1(1): 293–318.Google Scholar
Gilardi, F. (2002), ‘Policy Credibility and Delegation to Independent Regulatory Agencies: A Comparative Empirical Analysis’, Journal of European Public Policy, 9(6): 873–893.Google Scholar
Gilardi, F. (2005), ‘The Formal Independence of Regulators: A Comparison of 17 Countries and 7 Sectors’, Swiss Political Science Review, 11(4): 139–167.Google Scholar
Gilardi, F. (2008), Delegation in the Regulatory State: Independent Regulatory Agencies in Western Europe (Cheltenham: Edward Elgar).Google Scholar
Groenleer, M. (2009), The Autonomy of European Agencies (Delft: Eburon).Google Scholar
Gulland, A. (2013), ‘NICE Confirms its Role in New NHS after Government U Turn’, British Medical Journal, 343: d4525.Google Scholar
Ham, C. and Robert, G.B. (2003), Reasonable Rationing: International Experience of Priority Setting in Health Care (Philadelphia: Open University Press).Google Scholar
Joerges, C. and Neyer, J. (1997), ‘From Intergovernmental Bargaining to Deliberative Political Processes: The Constitutionalisation of Comitology’, European Law Journal, 3(3): 273–299.Google Scholar
Klein, R. (2010), The New Politics of the NHS: From Creation to Reinvention, 6th edn (Oxford: Radcliffe Publishing).Google Scholar
Knight, J. (1992), Institutions and Social Conflict (Cambridge: Cambridge University Press).Google Scholar
Koop, C. (2011), ‘Explaining the Accountability of Independent Agencies: The Importance of Political Salience’, Journal of Public Policy, 31(2): 209–234.Google Scholar
Laffont, J.-J. and Tirole, J. (1991), ‘The Politics of Government Decision-making: A Theory of Regulatory Capture’, Quarterly Journal of Economics, 106(4): 1089–1127.Google Scholar
Landwehr, C. and Böhm, K. (2011), ‘Delegation and Institutional Design in Health Care Rationing’, Governance, 24(4): 665–688.Google Scholar
Mair, P. (2013), Ruling the Void. The Hollowing out of Western Democracy (London: Verso Books).Google Scholar
Majone, G. (1996), Temporal Consistency and Policy Credibility: Why Democracies Need Non-Majoritarian Institutions , Robert Schumann Centre Working Paper 96(57) (Florence: European Union Institute).Google Scholar
Majone, G. (1997), ‘From the Positive to the Regulatory State: Causes and Consequences of Changes in the Mode of Governance’, Journal of Public Policy, 17(2): 139–167.Google Scholar
Majone, G. (2001), ‘Nonmajoritarian Institutions and the Limits of Democratic Governance: A Political Transaction-Cost Approach’, Journal of Institutional and Theoretical Economics, 157(1): 57–78.Google Scholar
Moe, T.M. (2005), ‘Power and Political Institutions’, Perspectives on Politics, 3(2): 215–233.Google Scholar
National Institute for Clinical Excellence (2000), Framework Document (London: NICE).Google Scholar
North, D.C. (1990), ‘A Transaction-Cost Theory of Politics’, Journal of Theoretical Politics, 2(4): 355–367.Google Scholar
Olson, M. (1982), The Rise and Decline of Nations: Economic Growth, Stagflation and Social Rigidities (New Haven: Yale University Press).Google Scholar
Ostrom, E. (1986), ‘An Agenda for the Study of Institutions’, Public Choice, 48(1): 3–25.Google Scholar
Pettit, P. (2003), ‘Depoliticizing Democracy’, Associations, 7(1): 23–36.Google Scholar
Sabik, L.M. and Lie, R.K. (2008), ‘Priority Setting in Health Care: Lessons from the Experiences of Eight Countries’, International Journal for Equity in Health, 7(4): 1–13.Google Scholar
Scharpf, F.W. (1989), ‘Decision Rules, Decision Styles and Policy Choices’, Journal of Theoretical Politics, 1(2): 149–176.Google Scholar
Schmidt, V.A. (2013), ‘Democracy and Legitimacy in the European Union Revisited: Input, Output and “Throughput”’, Political Studies, 61(1): 2–22.CrossRefGoogle Scholar
Sieber, U. (2010), Gesunder Zweifel: Einsichten eines Pharmakritikers – Peter Sawicki und sein Kampf für eine unabhängige Medizin (Berlin: Berlin Verlag).Google Scholar
Silberman, B.S. (1993), Cages of Reason: The Rise of the Rational State in France, Japan, the United States, and Great Britain (Chicago: University of Chicago Press).Google Scholar
Taylor, A. (1997), “Arm’s Length but Hands on”: Mapping the New Governance: The Department of National Heritage and Cultural Politics in Britain’, Public Administration, 75(3): 441–466.Google Scholar
Thatcher, M. (2002), ‘Regulation after Delegation: Independent Regulatory Agencies in Europe’, Journal of European Public Policy, 9(6): 954–972.Google Scholar
Thatcher, M. and Stone Sweet, A. (2002), ‘Theory and Practice of Delegation to Non-Majoritarian Institutions’, West European Politics, 25(1): 1–22.Google Scholar
Thatcher, M. and Stone Sweet, A. (2003), The Politics of Delegation (London: Cass).Google Scholar
van Thiel, S. (2001), Quangos: Trends, Causes, Consequences (London: Ashgate).Google Scholar
van Thiel, S. (2004), ‘Trends in the Public Sector: Why Politicians Prefer Quasi-Autonomous Organizations’, Journal of Theoretical Politics, 16(2): 175–201.Google Scholar
Weaver, R.K. (1986), ‘The Politics of Blame Avoidance’, Journal of Public Policy, 6(4): 371–398.Google Scholar
Wonka, A. and Rittberger, B. (2010), ‘Credibility, Complexity and Uncertainty: Explaining the Institutional Independence of 29 EU Agencies’, West European Politics, 33(4): 730–752.Google Scholar
Wood, M.A. and Flinders, M. (2014), ‘Rethinking Depoliticization: Beyond the Governmental’, Policy and Politics, 42(2): 151–170.Google Scholar