Tactical Advantages Versus Administrative Heter Ogeneity

The argument examines two contrasting views of state authority in France and reopens the question of “strong” versus “weak” states. To do so, it explores the traditional Rousseauian view of the strong state and contrasts it to an opposing view that emphasizes administrative heterogeneity even in so-called strong states. The argument applies these views to the French state and develops a reconciliation of them. I argue that it is useful to conceive of state authority and structures in terms of “tactical advantages” that states may or may not have at their disposal in relations with civil society. State traditions structure over time the tactical advantages states may have. Strong state structures and the tactical advantages these give to the state enable it to shape politics by employing more effectively policy instruments to induce and constrain political behavior and policy outcomes. The state's tactical advantages influence what interest groups do politically and their effectiveness. Thus the French state possesses tactical advantages that enable it to structure the role interest groups play. The “weaker” American state, by contrast, does not possess tactical advantages that give it a comparable capacity to dictate inducements and enforce constraints on politics. But there are also important limits to the French state's strength. One of the most important of these is the French state's vulnerability to direct action, or exit from normal politics.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Special issue: "Legacies and latitude in European health policy"

This issue was guest edited by the authors listed

Changing choices in health care: implications for equity, efficiency and cost

Although choice may be seen as an end in itself, the papers included in this special issue of Health Economics, Policy and Law, examine choice policies in European systems of health care, which aim to be effective instruments for ameliorating the systemic pressures from the iron triangle of equity, efficiency, and cost. Three papers consider the nature of differences between and within countries following the Beveridge and Bismarck models of financing and organising the delivery of care, and how choices are changing within different systems. Within countries following the Beveridge model, current policies in England, Denmark and Sweden emphasise increasing patient choice of provider. Within countries following the Bismarck model, current policies in France and Germany seek to restrict choice of specialists by introducing ‘soft’ gatekeeping; and in the Netherlands there is a system of managed competition with choice of insurer that, in principle, allows insurers to contract selectivel