Delegation and Institutional Design in Health-Care Rationing
Article first published online: 20 SEP 2011
© 2011 Wiley Periodicals, Inc.
Volume 24, Issue 4, pages 665–688, October 2011
How to Cite
LANDWEHR, C. and BÖHM, K. (2011), Delegation and Institutional Design in Health-Care Rationing. Governance, 24: 665–688. doi: 10.1111/j.1468-0491.2011.01542.x
- Issue published online: 20 SEP 2011
- Article first published online: 20 SEP 2011
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.