Political Institutions Flashcards
What do we mean by ‘institutions’?
“The ‘rules of the game’ determining how government and the wider state operate. Institutions can be formal structures and procedures, but also informal norms of behaviour that may not be written down.”
Buse et al. 2012
Institutional sociologists
An institution is a relatively enduring collection of rules and organisational practices, embedded in structures of meaning and resources that are relatively invariant in the face of turnover of individuals and relatively resilient to the idiosyncratic preferences and expectations of individuals and changing external circumstances” March and Olsen, 1989
Federal vs unitary systems
• Verticalpowersharingbetweenthecentreand the periphery
• Federalism
– A federation of states, with elected governments, based on a constitution (US; Germany)
– Typically represented through two chambers; both may have responsibility for health policy
• Decentralisation
– Political (devolution): with elected regional or local
governments (Sweden; Denmark; UK; Italy)
– Administrative (deconcentration): e.g. regional health authorities (France)
Democratic institutions
• Strong (democratic) institutions are a condition for the control of power
– checks and balances
– shared decision-making
– ensure public accountability – create legitimacy and trust
• Dysfunctional/weak institutions tend to privilege those in power and their interests
– Institutions can fail and they can be misused
Dilemmas of institutionalism
– Institutional inertia, e.g. US healthcare reform
– Institutional weakness, e.g. health system corruption
High income countries (mature democracies):
• Constellationsofpoliticalinstitutionscanpose barriers to (health) policy change
• Institutionalinertia/institutionaldecay
Middle and low income countries:
• Weak,immatureorabsentpoliticalinstitutions pose barriers to democracy and to development
• Focusonbuildinginstitutions(legal,economic, political)
Getting the balance right is difficult!

Veto players (Tsebelis 2002)
• Policy change (through legislation) relies on agreement by a specific set of actors (‘veto players’)
– Process rules determined how and when these actors are involved (‘veto points’)
• ‘Veto players’ and/or ‘veto points’ determine the options for and pace of policy change
• Determine what is politically feasible
– Health insurance reform in the US? Austerity package in Southern European countries
Path Dependency
• Political science concept: – Historical institutionalism
• Past choices shape future options
• Institutions
– Are like “dried concrete” – can be uprooted, but the effort is substantial
– Create stability, routine, trust, legitimacy
• Emphasises continuity of institutions and high transaction costs of change
– Building institutions takes time and effort
Role of Judiciary
• Third power of the state
– Judicial review: Ensures that government abides to the rule of law and that legislation is in line with the constitution (or other law)
– Protect the rights of citizens set out in a constitution (or other law, e.g. EC Human Rights Act)
• Courts seem to play a growing role in challenging legislation/government
– How independent? Political appointments?
Weak/incomplete institutions
• Weakness or absence of institutions reduces potential political stability
– Absence of rules; creates political instability • Governments focus on short term goals
– Placating specific groups crucial to their political survival (e.g. urban vs. rural; ethic or religious groups; party members); neo-paternalism
• Less interested in achieving long term goals
– Such as improving social welfare, extending education to all, building the health care system etc.
Characteristics of liberal democracies (Offe, 2012)
• Ruleoflaw
– Enforceable law; possibility of judicial review; absence
of corruption • Statecapacity
– Capacity to formulate and implement policy; to collect and allocate resources; knowledge and information
• Substantialcontestation
– Rules of competition for power; electoral rules; party
funding; transparency; justification of decisions • Effectiveaccountabilityofrulers
– Procedural through elections; public/media scrutiny; an educated, interested citizenry
