Institutional theories. The role of political institutions Lecture 7

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Institutional theories. The role of political
institutions Lecture 7

• Health Politics
• Ana Rico
• ana.rico_at_medisin.uio.no

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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

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SOCIAL POLITICAL THEORIES
L7
L3
1950s/60s SOCIAL CONTEXT
OLD INSTITUTIONALISM Formal political institutions
SOCIAL PRESSURES
L2 L4
SOCIAL ACTORS (IGs dependent on social pressures)
L5
POLITICAL ACTORS (STATE independent of social
pressures)
1970s/1980s ACTOR-CENTRED
L6
SOCIOP. ACTORS (STATE-SOCIETY interdependent)
1990s INSTITUT-IONALISM (state-society)
L7
NEW INSTITUTIONALISM (state institutions
state/PPs/IGs organization)
L9
L4 L9
L7 L9
POWER-CENTRED THEORIES (interactions among
collective actors social structure)
2000s ACTION THEORIES
RATIONAL CHOICE (interactions among individuals
ACTOR-CENTERED INSTITUTIONALISM (interactions
among institutions elites)
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CONCEPTS (4) The state

• 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

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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

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The old institutionalism
Types of democratic institutions in the EU
Lijphart 1984
Later US research shows that Presidentialisms
disperses power more
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The old institutionalism

• Other arguments and counterarguments (1)
• LIJPHARTS 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 (minoritiesrepresentation
  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 change
• Actor-centred institutionalism
• Institutions which disperse state power allow
  more points of acess (veto points) for IGs to
  block policy

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The old institutionalism

• Arguments and counterarguments (2)
• 1. LIJPHARTS 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

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The old institutionalism
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 lt
Prop gt Electoral thresholds gt
lt District magnitude Small Big
Ballot structure 1/2
rounds Supplementary seats No Yes C. The
social and socioP power structure Cleavages
pol. parties
Lijphart 1984
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The DoP between Executive Parliament
The electoral system
Lijphart 1994
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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

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Formal informal institutions
SOCIAL CONTEXT
CULTURE
POLICY (SUB-) SYSTEM

• Social organiz.
• Associations
• Churches
• Firms

THE POLITICAL SYSTEM
Ideologies Ideas

• Sociopol. actors
• IGs Prof Ass. Unions
• Citizens Mass media
• Political parties

Policy change
c
a

• State actors
• STATE- POL. PARTs (IGs)

Org.Struct.
Policy paradigms/ legacies
Subcultures /pol.identities
b
HC SYSTEM
CONSTITUTION

• Interactions
• Coalitions/competit.
• Leadership/strategy

Social groups - Communities - Ethnia
gender - Social classes

• Institutions
• Const. (interorg.)
• Organiz. Struct.

Outputs
e
d
f
Outcomes
OUTPUTS
INPUTS

• Demands and supports
• Access to the political system
• Decision-making

d. Institutional change e. Impact of policy f.
Distribution of costs and benefits
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The new institutionalism

• 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

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Immergut 1992
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Actor-centred institutionalism
Determinants of National Health Insurance systems

Immergut 1992
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Veto points
SOCIAL CONTEXT
POLICY CONTEXT

• Social organiz.
• ASSOCIATIONS
• CHURCHES
• FIRMS

THE POLITICAL SYSTEM

• Sociopol. actors
• NEW SOCIAL MOV.
• MASS MEDIA
• IG PROF ASS
• POLITCAL PARTIES

• Policy actors
• STATE ACTORS
• IG PROF ASS
• POLITCAL PARTIES

a
c
Policy change
Implemen- tation
b

• Social groups
• COMMUNITIES
• ETHNIA GENDER
• SOCIAL CLASSES

Institutional framework
HC services
Interactions
Outputs
d
e
f
Outcomes
OUTPUTS
INPUTS

• Demands and supports
• Access to the political system
• Decision-making

d. Institutional change e. Impact of policy f.
Distribution of costs and benefits
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Actor-centred institutionalism

• (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

Maioni 1997
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CAUSES OF NHI CANADA vs USA
Maioni 1997
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FEDERALISM IN EU HC
NORDIC COUNTRIES
FISCAL FED.
CENTRAL COORD.
POLITICAL DEVOLUTION
ITALY /SPAIN
FISCAL FED.
CENTR
POL. DEVOLUTION
POL. DEV.
UK / GREECE / (PORTUGAL)
60s 70s 80s
90s 00s
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FEDERALISM impact of DoPower
Political OUTCOMES (for democratic
representation)
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POLICY IMPLICATIONS

• 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-institutionali
  sm) 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

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CRITICISMS

• 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)