Book review: Sustainable Development Goal 16: Focus on public institutions, World Public Sector Report 2019. United Nations, Division for Public Institutions and Digital Government, Department of Economic and Social Affairs, New York, 2019, pp. 219

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The Effect of EU Membership on the Health Care Systems of Member Countries in Central and Eastern Europe

Health and health care provision are one of the most important topics in public policy, and often a highly debated topic in the political arena. The importance of considering European Union accession’s impact on the health care sector of new member countries is highlighted by studies showing that accession to the Union has significant impacts on the socio-economic indicators of the new members, while the impacts on the health care system are less known. This is particularly important for a Central and East European country such as Croatia, where a policy responsive government indicates a high level of quality of democracy (Roberts, 2009) and where issues in the health care system have been carried over from the previous regime. In this study, I summarize the current status of health care in the European Union and the reasons behind the failure to create a stronger legislative framework around health care issues and its consequences. I find that the absence of more meaningful hard laws has stimulated the creation of alternative soft law practices to harmonize health systems across the Union, with uncertainty about its impact on health outcomes in new member countries, including Croatia

National institutional arrangements for implementation of the Sustainable Development Goals: A five-year stocktaking, World Public Sector Report 2021

National institutional arrangements for implementation of the Sustainable Development Goals: A five-year stocktaking, World Public Sector Report 2021

The role of the European Union in health policies of member states – an example of the rare diseases policy in Croatia

Aim To assess the European Union’s (EU) impact on the Croatian health policy, and identify which mechanisms and processes were used to shape a particular health policy on the EU and national levels. The study focused on the rare diseases policy to obtain a better insight into the process of policy shaping, starting at the EU level and moving down to the Croatian national level. Methods We conducted actor analysis, policy networks, and semi-structured qualitative interviews with key policy actors at the EU and domestic level. The analysis of actors included actor mapping, the analysis of their relationships, and of their interdependence. Policy networks involved identifying key actors and analyzing them separately to create both policy networks to explain their hierarchy and relationships. Semi-structured interviews included ten key experts at the EU and national health policy levels. Results The implementation of the EU health policy is complex. Hard and soft law were complementary in the way they affected the translation of EU rare diseases policy into Croatian law. Strong and interconnected EU and domestic actors were significant in this process, which resulted in the creation of Croatia’s rare diseases policy. Conclusion Given that the rare diseases policy area is a developing policy area, this study contributes to a better understanding of the implementation of the EU health policy, clarifying a mechanism that can enable national governments to adopt specific health policies

International Medical Knowledge Transfer as a Tool of Public Diplomacy: The Case of Croatia

The international dissemination of expertise in most transition countries is underdeveloped because of a number of developmental and practical challenges. Croatia’s overall educational and innovatory potential for health knowledge transfer remains above average when compared to what has been achieved by other new EU Member States, and it is dominated by public sector research institutes and universities. This unrealized potential could be improved further by enhancing the international dissemination of Croatian medical expertise using public diplomacy. The aim of this paper is to address the way in which the international dissemination of medical expertise in transition countries can serve as a tool of public diplomacy to improve its scope and success, in addition to advancing the scope of the knowledge transfer itself. The case of Croatia is used as an example. An effective communication strategy is an important element of public diplomacy that, by influencing public opinion, provides the necessary precondition for active societal support of the willing participants in the transfer of knowledge. Hence, at the beginning of this paper we present the concept of international knowledge transfer in general, and then proceed to present the example of the transfer of Croatian medical knowledge. The second part of this paper addresses elements of public diplomacy and different communication mechanisms and the potential for the international dissemination of domestic medical expertise, with the primary emphasis on Croatia. Finally, we present an overall analysis and an algorithm of public diplomacy activities that each country in transition can adopt to overcome failures associated with the international dissemination of medical expertise

Nestabilnost stranaka, institucionalni poticaji i korupcija u novim demokracijama

Corruption is widely viewed as a detriment to consolidation in new democracies. In this paper we argue that new democracies face a particular dilemma that makes corruption more likely. Specifically, we suggest that information asymmetries exist between political elites and voters that make it difficult for new political parties to forge the long time horizons necessary for democratic institutions to mature. Political elites, whether they be cadres of the former authoritarian regime who recast themselves as committed to the new democratic project or formerly excluded opposition figures intent on establishing themselves in the new participatory order, lack information about the preferences of broad scale publics. These newly empowered voters, while possessing interests of their own, often lack the ability to determine the precise platform positions of new political parties as well as the likelihood that candidates are committed to the long-term strengthening of democratic values. As a consequence, new political parties may have a disincentive to establish clear and ideologically precise platform positions that they can commit to over time. Instead, they have incentives to try and cultivate bases of voter support through the use of bribes, political favors, and other nepotistic practices that, while useful in the short-term, undermine long-term democratic legitimacy. We suggest that, to the extent that political elites value political office more than the development of a clear and consistent space in the political spectrum, parties in new democracies are unlikely to eschew corrupt practices. We examine party fractionalization indices as a way to capture this uncertainty and use a case study of Croatia to develop our core arguments.Korupciju se općenito smatra štetnom za konsolidaciju novih demokracija. U radu se provjerava teza da su nove demokracije suočene s dilemom koja korupciju u njima čini vjerojatnijom pojavom. Smatra se da postoji asimetričnost u dostupnosti informacija političkim elitama i građanima koja otežava novim političkim strankama stvaranje dugoročnih planova koji bi omogućili dozrijevanje demokratskih institucija. Političkim elitama, tvorili ih kadrovi iz bivših autoritarnih režima koji su se reorijentirali prema tom novom demokratskom projektu, ili pak u prošlosti marginalizirani opozicionari kojima je cilj etablirati se u novom višestranačkom poretku, nedostaju informacije o očekivanjima i prioritetima šire javnosti. Ti novoosnaženi glasači, premda imaju vlastite interese, često nisu sposobni odrediti točna programska stajališta novih političkih stranaka kao ni vjerojatnost da su njihovi kandidati posvećeni dugoročnom jačanju demokratskih vrijednosti. Zato nove političke stranke nemaju interesa uspostaviti jasna i ideološki precizna programska stajališta koja bi mogle učvršćivati tijekom vremena. Umjesto toga, okolnosti ih potiču da pokušaju uspostaviti temelje podrške glasača upotrebom mita, činjenjem političkih usluga te drugim nepotističkim praksama koje, iako kratkoročno korisne, dugoročno potkopavaju demokratski legitimitet. Autori smatraju da će se, tako dugo dok političke elite više drže do političkog položaja nego do razvoja jasno definiranog i dosljednog vlastitog prostora u političkom spektru, političke stranke u novim demokracijama teško odreći koruptivnih praksi. Autori analiziraju indekse frakcionalizacije stranaka kao jedan od načina da ovladavanja spomenutom nesigurnšću, te koriste studiju slučaja Hrvatske kako bi dodatno razvili svoje temeljne argumente

The Domestic Politics of Entering International Communities: An Exploratory Analysis

In the last thirty years, there has been a significant increase in the globalization process, or as other refer to it, the internationalization, free trade, or liberalization. This trend was reflected in the increasing number of newly formed international organization (economic and security) as well as in the increased membership in the already existing ones. The evidence of this trend has been particularly visible since the end of the Cold War, when the race of the Eastern European countries to enter international organizations has been as competitive as ever. Nonetheless, a number of countries, upon careful evaluation and consideration of membership, has opted out of the opportunity to enter such international agreements. The question that this paper addresses is how do countries decided whether to enter or not international organizations? In other words, what elements, processes, and motives lie behind the decision of countries to commit to a new membership? Most of the studies that have addressed this topic have done so from an international perspective as they addressed the politics between countries, as well as the costs and benefits in terms of power, sovereignty, and national income once in the organizations. This paper, on the other hand, approaches the issue from a comparative perspective, both economic and political. It attempts to answer the research question by looking at the domestic sources of decision -making and how they influence this decision. Namely, a decision to become more open to trade has several implications for a country, depending on its size, and already established trade openness, among other factors. The impact of increased openness will most seriously affect the domestic players, both negatively and positively. Thus, in considering the impact that the policy could have on their welfare, players align their interests in order to express their preferences on the issue to the decision makers. The ability of the domestic actors to have their preferences considered in turn depends on the structure of the institutions through which they can participate in the political process i.e. how are their votes turned into seats, and who has most impact in the policymaking. Thus, depending on the impact of globalization on a country's domestic welfare, as well as the composition of the domestic players (export versus import intensive), the decision of the country on whether to participate or not will finally depend on the preference filtering mechanism given by the electoral and representative systems a country has. Thus, the decisions to join or not to will sometime reflect a special interest, while at other times it will be the result of an agreement reached by all of the existing groups

Zdravstvena politika u novim članicama EU-a: izazovi za Hrvatsku

Problemi zdravstvenih sustava i zdravstvenih politika u zemljama članicama Europske unije postali su uočljiviji širenjem europske integracije na srednju i istočnu Europu. Do toga je došlo ne samo zbog raznolikosti zdravstvenih sustava novih članica već i zbog utjecaja samog članstva u EU-u

The Impact of the World Bank on Health Care Reform in Transitional Economies

Why do some countries still experience high mortality rates and low health care sector effectiveness, thirteen years after the post-communist transition? Why have some been successful at addressing their health care needs while other left their public health in decay? This study attempts to answer the puzzle by looking at the role of World Bank assistance in the health care reforms of the Central and Eastern European countries during the transition period. It does so by focusing at the type of reform undertaken by countries, as well as at the significance of the loan amount and the ability of the countries to “absorb” the loans successfully, that is, to use the resources given effectively. The results indicate that those countries that reformed earlier and developed strong institutions, were also more likely to use the World Bank loans more efficiently to reform their health care sector. Thus, the effectiveness of their health care system was higher than that of countries that undertook gradual reforms, received less World Bank assistance, and whose institutions were weak