Explaining informal payments for health services in Central and Eastern Europe: an institutional asymmetry perspective

The aim of this paper is to propose and evaluate a new institutional theory explanation for patients making informal payments for health services in Central and Eastern Europe. This views informal payments by patients to healthcare professionals as arising when formal institutional failures lead to an asymmetry between the laws and regulations of formal institutions and the unwritten rules of informal institutions. Reporting a 2013 Eurobarometer survey of the prevalence of informal payments by patients in Central and Eastern European countries, a strong association is revealed between the level of asymmetry between the formal and informal institutions, and the propensity to make informal payments. The association between informal payments and various formal institutional imperfections is then explored to evaluate which structural conditions might reduce this institutional asymmetry, and thus the propensity to make informal payments. The paper concludes by exploring the implications for tackling such informal practices

Evaluating working conditions in the informal economy: evidence from the 2015 European Working Conditions Survey

Although it is widely held that working conditions in the informal economy are worse than in the formal economy, little evidence has been so far provided. The aim of this article is to fill this lacuna by comparing the working conditions of informal employees with formal employees using the 2015 European Working Conditions Survey. Multilevel mixed-effects logistic regression analysis provides a nuanced and variegated appreciation of which working conditions are worse for informal employees, which are no different, and which are better for informal than formal employees. The article concludes by discussing the theoretical and policy implications

Tackling Undeclared Work in Bulgaria: Knowledge-Informed Policy Responses

Undeclared work is socially accepted and widely practiced in Bulgaria. The undeclared economy is estimated at roughly a third of GDP. Nearly one in ten people do some undeclared work. Undeclared work is motivated primarily by lack of trust between the people and the authorities. It involves mostly people who voluntarily exit the declared economy but also those that are excluded. The conventional repressive approach to tackling undeclared work has exhausted its effects in Bulgaria. It should be complemented with more curative, preventative and commitment policies. Policymakers should consider not just the rational but also the social actor approach which tackles trust issues and the asymmetry between formal and informal rules. Authorities should continue modernising institutions and should increase social spending and public awareness campaigns