Delegation and Institutional Design in Health-Care Rationing

• 成果类型: Article
• 署名作者: Landwehr, Claudia; Boehm, Katharina
• 署名单位: Johannes Gutenberg University of Mainz
• 刊物名称: GOVERNANCE-AN INTERNATIONAL JOURNAL OF POLICY ADMINISTRATION AND INSTITUTIONS
• ISSN/ISSBN: 0952-1895
• DOI: 10.1111/j.1468-0491.2011.01542.x
• 发表日期: 2011
• 关键词: independent regulatory agencies; POLICY

摘要

The delegation of decision-making powers to nonmajoritarian, independent agencies has become a significant phenomenon in more and more policy areas. One of these is the health-care sector, where decisions on the range of services covered within public systems have, in most developed countries, been delegated to specialized bodies. This article offers an analytical framework that seeks to grasp the empirical variety and complexity of delegative processes and appointed institutions. The framework is used to describe decision-making processes and institutions in six countries: Austria, Germany, Norway, Sweden, New Zealand, and the United Kingdom. We find that, although constrained by preexisting institutional structures and traditions, delegators enjoy a considerable degree of discretion in their institutional design choices and engage in strategic design and redesign of appointed bodies.