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PAPM 2000 March 19, 2014.docx

3 Pages

Public Affairs and Policy Management
Course Code
PAPM 2000
Graeme Auld

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Health Care- Case Study PAPM 2000 Policy: Analysis, Implementation and Evaluation • Policy Change and Federalism o Veto Playres o Accountability • The case of Health Care Retrenchment o Canada v. Germany v. Retirement Comparative analysis: o What is its value? Why do we do it? o Why is it potentially valuable for policy analysis? o What are its weaknesses? Provides a means to better understand the opportunities and constraints created by our system of governmen o May have implications for the feasibility of particular policy designs or the ease of implementing particular program o Healthcare retrenchment is one case open to exploration Paper presents dilemma for reformers o How to cut spending (control costs) with out paying the political costs that come with expenditure control Serious dilemma o Open ended commitment to funding healthcare, problematic for government budgets o But, cost-containment very unpopular with citizens (little support for reductions in funding) o And, face powerful incumbents in health sector that stand to lose from reforms Given thsee consistent pressures, why do we see different levels of retrenchment (ie. Cost control) • Presents a two-variable model o Number of Veto players o Opportunities for "blame avoidance" • Different governmental institutions provide variation on these two variables • Premise: Actors that must agree to changes from default solutions, will only agree to changes when it is in their interest to do so • Different systems of government have different numbers of veto players • Leads to expectation that change will be harder in some countries than other o Greater status quo bias • Tsebelius (1995) defines three features of veto players that affect policy stability o As the number of veto players increase, winset for moving from status quo does not get larger (ie. Increased stability) o If veto players are collectives, increasing collective group members the area of the winset increases (ie. Decreased policy stability) Opporotunity for "blame avoidance" • Premise: loss aversion can lead to political backlash when program funds are cut or not increased commensurate with increased costs • Reformers will face potential political backlash and hence o Will seek to find ways to obfuscate reforms, complicating lines of accountability o Make hard to predict consequences of policy or trace political accountability after the fact Two variables: dilemma of Reformers •More veto players increase the challenge of getting reforms passed •Fewer veto players -< fewer reforms •Question for paper: how do different institutional environments affect the balance between these two variables? The Cases: •Two Federal systems o Germany -> power-sharing federaism • Interlacing of federal/regional responsibilities o Canada -> Power-sharing/federalism
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