Political Institutions

This chapter surveys theories and empirical evidence about the impact of state structures and political institutions on welfare state structures and outcomes. It shows that the political-institutional analysis of welfare states has shifted over time from an interest in static structures to a much more dynamic analysis of the interplay amongst preferences, structures, ideas, and institutions. It reviews different approaches to the study of political institutions, including majoritarian versus consensus democracy, veto points, and veto players. The impact of veto points on welfare state development and change, as well as the links between electoral systems and electoral dynamics on social policy outcomes, are explained and discussed. The chapter concludes with a review of the impact of past policies on welfare state politics and outcomes.

Veto Points Revisited: The Role of Party System Institutionalization in Welfare State Change

This article argues that the impact of veto points on a government's policy outcomes depends crucially on the degree of institutionalization of the party system. Specifically, the article claims that two dimensions of party system institutionalization – stability of relations between parties and between parties and voters – condition the ability of the opposition to block governments' policy plans through veto points. It showcases this argument by applying the method of causal process tracing to a comparative analysis of health policy reforms in Slovakia (2002–2004) and Hungary (2006–2008).

Poland

This chapter offers an in-depth look at health politics and the universal health system in Poland, financed through social health insurance. It traces the development of the Polish healthcare system under communism, characterized by a complete shift from an insurance system to a state-run Soviet Semashko model of healthcare with some elements of private provision. Since 1989, Polish health policy went through systemic changes which included a shift to a decentralized social health insurance system in the late 1990s and re-centralization in 2001. Polish healthcare politics has been turbulent, marked by political instability matched by a dense network of veto points, including the President and the judiciary, that had an impact on the direction of health reforms. As the chapter highlights, some of the main issues have been high out-of-pocket payments, corruption, and privatization and commercialization of public hospitals.

Health Politics Today

This chapter sets the stage for Health Politics in Europe: A Handbook by explaining the motivation for the HEALTHDOX study upon which it is based, introducing the key themes and concepts, and providing an overview of the historical development and institutions of European healthcare systems, as well as current political conflicts and policy trends. The chapter explains how European health systems have been shaped by several centuries of political development, featuring a series of regime crises and challenges. It takes a closer look at political and policy developments since 1989, which importantly included the privatization of most Eastern European healthcare systems and experiments with new public management in Western Europe, recapping the highlights of the book’s thirty-five country cases. The chapter provides definitions and examples of the main types of healthcare financing in Europe and highlights the variation in the public–private mix and extent of out-of-pocket payment. The main theories for analyzing health politics are presented, including the concept of political veto points, and their significance for health politics.

The system of government and the opposition in Poland after the 2015 parliamentary elections

The category of the system of government in Poland requires reference to ‘the governance style’ of the right, and to the tendency that has appeared in international politics in recent years to call it populist nationalism. The objective of this paper is to show that in the case of Poland after 2015, the thesis of the retreat of democracy has no factual grounds, and it can be countered through the use of evidence. The system of government in Poland after the Law and Justice party came to power cannot be described as a contradiction to democracy. Citizens are not being manipulated and deceived. They are aware of the content of decisions made by the executive branch. The opposition is able to act freely, and it is supported by independent private media. There are many veto points in the political system. The government can count on public support that is stronger than that of the governments from the period before 2015.

COMING TOGETHER BUT STAYING APART: CONTINUITY AND CHANGE IN THE AUSTRIAN AND SWISS VARIETIES OF CAPITALISM

This chapter assesses institutional continuity and change in the varieties of capitalism in Austria and Switzerland. In the face of growing internationalisation, budgetary constraints and European integration, continuity and change have been determined by prevailing interest configurations and institutional limits in terms of public intervention and private governance. Hence, private employer dominance in Switzerland has fostered ra- pid change in areas where private regulation prevailed, such as corporate gover- nance, whereas institutional veto points have strongly limited change in areas where public intervention was necessary. By contrast, the larger scope of public intervention in Austria and its more majoritarian features have allowed more space for change in welfare reforms while the strong institutionalisation of corporatist institutions in labour market governance, for instance, has made it more resilient to change than Switzerland. In this respect, Austria and Switzerland provide good examples of how institutional change is dependent on the respective share of public regulation and private governance.

Intergovernmental veto points in crisis management: Italy and Spain facing the COVID-19 pandemic

Italy and Spain were the first countries affected by the shift of the pandemic epicentre from east to west. The rapid spread of the virus in allegedly similar social settings, the relatively high numbers of cases and casualties, and the adoption of drastic containment measures were similar in the two countries during the first wave of the pandemic. Both countries are enmeshed in an unstable political equilibrium at the centre, governed by recently established national political coalitions that have continuously been called into question and exposed to significant public debt. The two countries differ in the role of the executive vis-a-vis the legislative, and the tensions between central coordination and regional centrifugal forces. To improve the understanding of how the pandemic has influenced decision-making and crisis management, this article explains the relevance of institutional veto points, as well as differences between the two countries. There is room to match coordination, policy capacity and shared accountability through more collaborative governance. Points for practitioners Governing a transboundary crisis that involves different governmental levels is about creating an effective coordination mechanism that clarifies responsibilities, avoiding those who may block decision-making processes (veto players) through being incentivized to do so due to the absence of adequate shared accountability systems. National and regional managers should realize that the separation of territorial powers not accompanied by political coordination jeopardizes policy capacity in both the short and long term.

Drivers of Carbon Price Adoption in Wealthy Democracies: International or Domestic Forces?

Is carbon price adoption in wealthy democracies driven more by international or domestic forces? Event history analyses reveal that carbon price adoption is more likely in countries with less fossil fuel energy use (and, by proxy, less powerful fossil fuel business-elite actors) and with less encumbered democratic institutions (i.e., fewer institutional veto points). These findings are triangulated through cross-sectional comparisons and case studies. In short, wealthy democracies enact carbon prices according to the degree to which domestic actors or costs constrain or enable enactment and implementation. The author argues that the global free-rider problem, posed by nonbinding international climate agreements and lack of enforcement, and fossil fuel business-elite power undermine the force of international values and norms. World society scholarship should attend more to (1) whether international participation incurs substantial local costs or powerful stakeholder opposition and (2) whether the benefits of such participation are more domestically or globally distributed.

Populism in Power and Democracy: Democratic Decay and Resilience in the Czech Republic (2013–2020)

Populism and technocracy reject vertical accountability and horizontal accountability. Populism and technocracy can combine to form ‘technocratic populism.’ The study assesses the extent to which democratic decay can be traced to the actions of technocratic populists as opposed to institutional factors, civil society, fragmentation and polarization. The main findings of this article are that technocratic populism has illiberal tendencies expressed best in its efforts at executive aggrandizement (cf. Bermeo, 2016). Without an effective bulwark against democratic erosion (cf. Bernhard, 2015), technocratic populism tends to undermine electoral competition (vertical accountability), judiciary independence, legislative oversight (horizontal accountability), and freedom of the press (diagonal accountability). The most effective checks on technocratic populist in power, this study finds, are the courts, free media, and civil society. This article highlights the mechanisms of democratic decay and democratic resilience beyond electoral politics. It indicates that a combination of institutional veto points and civil society agency is necessary to prevent democratic erosion (cf. Weyland, 2020). While active civil society can prevent democratic erosion, it cannot reverse it. Ultimately, the future of liberal democracy depends on the people’s willingness to defend it in the streets AND at the ballot box.

Alcohol policy, multi-level governance and corporate political strategy: The campaign for Scotland’s minimum unit pricing in Edinburgh, London and Brussels

The Scottish government’s plans for a minimum unit price for alcohol were vehemently opposed by the alcohol industry leading to a 6-year delay in implementation after legislation was passed. This article seeks to explain the consequences of devolution and European Union membership for the development of minimum unit price in Scotland through the concepts of multi-level governance, veto points and venue shifting. Systems of multi-level governance create policy interdependencies between settings, an increased number of veto points at which policies can be blocked, and the potential for policy actors to shift decision-making to forums where favourable outcomes are more likely to be attained. In the minimum unit price debates, the alcohol industry engaged in multiple forms of venue shifting and used regulatory compliance procedures and legal challenges at the EU level to try to prevent and delay the policy. This has led to a ‘chilling effect’ on subsequent alcohol policy developments across the United Kingdom.