Legitimacy and activities of civil society organizations

Civil Society Organizations (CSOs) play an active and noteworthy role in governance, both at the national and international level. Three questions arise: First, how do CSOs exercise their advocacy, what repertoires, strategies and resources do they use? Second, to what degree are they legitimized to do so? Third, are there systematic differences between member and non-member CSOs, respectively between policy fields? Based on a survey of 60 exemplary CSOs covering four distinct international-level policy making fora, we will inquire into these questions. The central finding is that membership CSOs neither differ substantially from non-member CSOs in their roles and strategies of dealing with International Organizations, nor do they differ in other aspects of legitimacy, such as transparency or inclusion of beneficiaries. There are no systematic patterns in CSOs properties or behavior which correspond to policy fields. -- Zivilgesellschaftliche Organisationen (ZGO) spielen im modernen Regieren eine wichtige Rolle, sowohl im Staat als auch auf internationaler Ebene. Drei Forschungsfragen stehen im Mittelpunkt dieses Papiers: Erstens, wie genau nehmen ZGO am Regierungsprozess teil und welche Einflussstrategien, Ressourcen und Handlungsrepertoire nutzen sie dabei? Zweitens, wie steht es um die Legitimation dieser Organisationen und ihrer Aktivitäten? Drittens, verhalten sich ZGO mit zahlreichen Mitgliedern systematisch anders als ZGO ohne Mitgliedschaft? Gestützt auf Daten von 60 transnationalen ZGO aus vier verschiedenen Politikfeldern gehen wir diesen Fragen nach. Zentrales Ergebnis ist, dass ZGO mit breiter Mitgliedschaft sich in ihren Rollenverständnis und ihren Einflussstrategien nicht grundlegend von anderen unterscheiden. Auch im Hinblick auf wichtige Aspekte ihrer Legitimität, wie etwa Transparenz oder Einbindung von Regelungsadressaten, gibt es keine auffälligen Unterschiede. Die Politikfelder, in denen ZGO aktiv sind, haben ebenfalls keinen messbaren Einfluss auf ihr Handlungsrepertoire und ihre politischen Strategien.

Delegation and Control in Health Care Systems : Vol. 1: Delegation and Control in 22 OECD Health Care Systems. A Data Handbook

Comparative research on the effects of institutional structures of health care systems is limited by the lack of comparable, detailed institutional information on the organization of health care systems. This data handbook describes the health care systems of 22 OECD countries on the basis of the institutional economics perspective, in particular from the perspective of delegation of medical as well as administrative tasks and the control mechanisms implemented in these delegation relationships, which shall avoid opportunistic behavior. On the conceptual level, the delegation-approach proved to be able to explain differences at the system level by rational individual behavior. Further, the delegation-approach offers a template by which a comparative analysis and the description of complex systems, like health systems, can be based. The data compiled in this data handbook shall enable researchers to study the impact of institutional structures on aspects of health system performance, like achievements in health levels, responsiveness and productive efficiency

Caring or Curing? On the Nature of Health Care in Modern Societies

Is health care a luxury or a necessity? Ever since the publication of Newhouse paper in 1977, this question has put forth a multitude of studies but still the substantive question is open. The empirical research on the nature of health care is mostly based on macro respectively micro level relationships among measures of wealth and expenditure for health care. Depending on the elasticity estimated, health care is classified by a study as a luxury, a necessity or both. Based on a micro level explanation of why wealth may change the preferences of citizens with regard to health care, this paper supplements these studies by making an inference from the satisfaction of the citizens with a health care system in combination with information on what the health care system is actually delivering on the preferences and expectations citizens hold with regard to health care and the health care system. Combining micro and macro level data, the evidence shows that wealth has indeed an effect on what citizens expect from a health care system. However, this change cannot be interpreted in the classical caring or curing distinction of medical services as proposed by Newhouse: even though curing, i.e. a health care system delivering what is necessary and performing well in restoring physiological health, surely no longer is enough to satisfy the citizens, the information available is insufficient to tell what the citizens actually want

Delegation and Control in Health Care Systems Volume 2: Institutions, Achievement, and Efficiency in 22 OECD Health Care Systems

This studies conceptualizes health systems as networks of delegation relationships. In these delegation relationships, actors may act opportunistically, and thereby lower the performance of the health system. The typical example is the supply-induced demand, the increase of the quantity of medical services provided by the providers for the reason to increase personal income. Counter measures consist of controlling these relationships. How can this be done? Internally, by installing appropriate incentives in the relationship (e.g. competition, provider remunerations which are independent from the quantity of services). Externally, by the state, i.e. the government. This may either directly intervene in the operation of the health system, for instance by setting the overall budget. Or the government may reform or threaten to reform the health system, in order to hold actors at bay. When is the government able to exercise external control? When it is not internally blocked, which it may be in the case of many direct veto players but also in the case of many indirect, societal veto players. The basic hypothesis is that the better organized the control, the higher the performance of the health system. The empirical implementation consisted in operationalizing and testing the hypothesis. The independent variables were operationalized by measuring delegation, internal, built-in control (in particular incentives), and measuring external control (governmental control and the capacity for reforms). The dependent variable performance was operationalized firstly by the level of health status, citizen’s satisfaction, but also the share of the health output, which is actually attributable to the health system. Secondly, it was operationalized by the efficiency by which these outputs were reached, i.e. whether doing so consumed many or few resources, but also the level and dynamics of expenditure. As for the results, the findings indicate no systematic effect of internal and external control on health system performance

Stuck in the Middle : Welfare Effects of the European Pharmaceutical Markets' Incomplete Integration and a Possible Remedy

The paper focuses on the regulation and parallel trade for innovative in-patent medicines in the setting of a partially integrated EU-wide market for pharmaceuticals, the impact of different national and European level regulatory regimes, under which the prices for theses innovative medicines are set, on the strategic entry decisions of research oriented pharmaceutical enterprises (ROPEs), the consequences thereof for the innovative capacity of the European pharmaceutical industry and the overall welfare of the European citizens.der which th