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Delegation and Institutional Design in Health‐Care Rationing
Author(s) -
LANDWEHR CLAUDIA,
BÖHM KATHARINA
Publication year - 2011
Publication title -
governance
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.46
H-Index - 76
eISSN - 1468-0491
pISSN - 0952-1895
DOI - 10.1111/j.1468-0491.2011.01542.x
Subject(s) - delegation , discretion , variety (cybernetics) , rationing , public administration , health care , grasp , business , economics , public relations , political science , public economics , economic growth , management , law , engineering , software engineering , artificial intelligence , computer science
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.