Studies of policy change have advanced to the point where the basic contours and factors driving policy sequences are now reasonably well identified and understood with a great deal of empirical evidence pointing to the prevalence of punctuated equilibrium processes in many policy fields. However the reasons why such processes occur is less well understood. Most attention to date has focused upon homeostatic models in which exogenously-driven shocks undermine institutionally entrenched policy equilibria. This article addresses the difficulties this account faces and the conceptual challenges which must be overcome to provide a solid grounding for the understanding and analysis of long-term policy dynamics. It focuses on the merits and demerits of alternative explanations featuring either random junctures and ‘positive-return’ sequences – path dependency – or embedded junctures and ‘reactive’ sequences – process sequencing. Models of policy-making over time using the latter two concepts, it is argued, are more likely to account for the large majority of policy dynamic than the former.

Policymaking and policy outcomes are not necessarily the result of a carefully designed process but can result from intertwined political and institutional dynamics that are often difficult to predict from the outset. This article examines such a policy process, the dramatic rise in the uptake of private health insurance (PHI) in Denmark. In a comprehensive welfare state, founded on the principle of universalism, its success is puzzling. The explanation suggested here is that the rise in PHI is an example of policymaking without policy choice. The article reviews the intended and unintended effects concerning equality in health care and public finance. It also notes that the introduction of a private alternative to the universal health care system has not weakened the support for the public services.

In mainstream welfare state theory the new institutional approach has explained incremental changes as institutions gradually adjust at the margin. However, big and sudden changes remain outside the scope of this theory. The article uses the theory of punctuated equilibrium to argue that politics is characterized by long periods of stability followed by dramatic bursts of change. The theory is tested on policy data from 18 Western countries, 1971–2002. It confirms that the degree of non-incrementalism depends partly on the institutional friction in a country and partly on the type of welfare programme in question.

Why do countries move from public to private financing of healthcare? This paper explores this issue by looking at the divergent reform trajectories of three postcommunist countries – the Czech Republic, Hungary, and Poland. While existing accounts emphasize veto points to explain changes in healthcare systems, the present analysis finds that moves towards private financing can be better explained by differences in access to the policymaking arm of the state. Specifically, a penetrable single-party government and weak bureaucratic capacities allow physicians to capture the reform process and implement their preferred policies. The results suggest that scholars of health policy should focus more attention on the actors seeking change and their access to policy makers.

The inauguration of Germany's grand coalition of Christian Democrats (CDU/CSU) and the Social Democrats (SPD) raises questions about the public policy performance of a coalition of ideological opposite. This paper turns attention to influence of coalition governments on the size of government in the German Laender from 1992 to 2005. We investigate whether grand coalitions at the sub-national level in Germany systematically affect government spending for education (including cultural affairs) and internal security. The article argues that the effects of grand coalitions on the size of the public sector are moderated by partisan politics but sometimes in unexpected ways. For example, government spending in the field of education is reduced when leftist parties are powerful in the Laender.

This article provides empirical evidence on ex ante and ex post indicators of regulatory quality and the relationship between those indicators and market performance in liberalised EU-15 network industries. It finds a low level of regulatory independence and competence, a high level of cross-country variations in regulatory quality, and widespread absence of correlation between ex ante regulatory quality and ex post performance indicators. On the basis of these findings, it suggests that the design of national regulatory agencies (NRAs) in Europe is not optimal and may be conducive to regulatory ineffectiveness or outright regulatory failure. Nevertheless, the existence and strengthening of EU-level regulators could enable EU member states to reduce the risk of regulatory failure by encouraging coordination and adoption of best practice.