Document Type

Working Paper

Publication Date

6-2022

Keywords

Decision Space, Pandemic, COVID-19, Public Health, Healthcare, Finance, Principal-Agent, Accountability, Electoral Support, Political Coalitions, Decentralization, Health expenditure, Health Policy, Political Parties, Algeria, Argentina, Australia, Austria, Bangladesh, Belgium, Finland, Guatemala, Hungary, Israel, Nigeria, Spain, Thailand, and Turkey

Abstract

We examined decision making in health using the Decision Space approach, which is rooted in the principal-agent theory. Countries analyzed were Algeria, Argentina, Australia, Austria, Bangladesh, Belgium, Finland, Guatemala, Hungary, Israel, Nigeria, Spain, Thailand, and Turkey. Researchers sought to analyze who was the de facto decision maker of health related decisions in each state. We have accomplished this through looking at government structures and the financing of health, which gave significant insight into who the primary authority on health is. Furthermore, we examined who holds this de facto decision maker accountable. In some cases it was the executive that did so, while in others it was a political coalition. We find that poorer countries tend to have increased expenditure by NGOs, and have a high presence of private health providers, driving up out of pocket spending and making those countries more accountable to private or external interests than to any domestic political coalitions.

Download

Share

COinS