The political process Action-centered theories. Lecture 8

1. The political processAction-centered theories.Lecture 8 Health Politics Ana Rico ana.rico@medisin.uio.no

2. OUTLINE OF THE SESSION (1) 1. Introduction to action-centred theory • Research questions & concepts • Comparison with other theories • Types of action-centred theories 2. Rational choice theories • Collective action & game theories 4. Modern action-centred theories in political science • Power-centred action theories, from: • State-society theory: Power resources (= power struggle) theories + Political participation and social movements (= social protest) • Social structuralism • Actor-centred institutionalism, from: • State-centred • Institutionalism

3. SOCIAL & POLITICAL THEORIES L7 L3 1950s/60s: SOCIAL CONTEXT OLD INSTITUTIONALISM Formal political institutions SOCIAL PRESSURES L2, L4 SOCIAL ACTORS (IGs: dependent on social pressures) L5 POLITICAL ACTORS (STATE: independent of social pressures) 1970s/1980s: ACTOR-CENTRED L6 SOCIOP. ACTORS (STATE-SOCIETY: interdependent) 1990s: INSTITUT-IONALISM (+state-society) L7 NEW INSTITUTIONALISM (state institutions & state/PPs/IGs’ organization) L9 L4, L9 L7, L9 2000s: ACTION THEORIES POWER-CENTRED THEORIES (interactions among collective actors & social structure) RATIONAL CHOICE (interactions among individuals ACTOR-CENTERED INSTITUTIONALISM (interactions among institutions & elites)

4. OUTLINE OF THE SESSION (2) I. Research questions • Do politics matter? Are action strategies and actors’ interactions the main determinant of policy? Who participates? Who governs? II. Main concepts - definitions • Policy-making, collective action, political participation, power resources, leadership, strategies. III. Thesis and arguments • Actors influence policy through leadership, coalitions & strategies IV. Aplications – evidence • American excepcionalism, political participation in Europe VI. Policy implications • Actors with less (financial or institutional) power resources can influence policy through coalition strategies and political leadership • Policy change requires divided stakeholders & united stakechallengers

5. RESEARCH QUESTIONS • Do politics matter? Do political action and interactions determine policy? • Can be subdivided in several related research questions: POLITICS GOVERNMENT • 1) Who participates (=seeks to 3) Who governs? influence)/influences policy? • 2) How do participants interact? 4) How it governs?  Who influences policy? Relevance: Ultimately a question about quantity/quality of representative vs. direct democracy

6. TWO DEMOCRATIC PROCESSES REPRESENTATIVE DEMOCRACY DIRECT “DEMOCRACY” RQ 3. Who governs(= makes policy)? RQ 2. Who influences policy? State context Sociopol. context Social context RQ 4. How it governs (= who benefit)? RQ 1. Who participates?(= seeks to influence policy)

7. CONCEPTS (1) • 1. Policy: • Course of action or inaction chosen by government in dealing with a problem • Set of interrelated decisions taken by political actors about selection of goals and means for achieving them in a given situation” • Set of rules issued by the state which allocate power and other resources among competing social actors’, and impose limits on their behaviour • 2. Policy-making: • Process through which political actorsmake, take, enforce and evaluate decisions which committ all members of a society • 3. Politics: • Process through which political actorsmake, take and enforce decisions which committ all members of a society (NOTE error in Lecture 3) • 4. Collective action: • Process through which social/socioP actors make, take and enforce group decisions • 5. Process • Dynamic evolution of political interactions and participant actors (‘ identities, resources, preferences, actions)

8. CONCEPTS (2) • 6. Political participation: • Individual and collective action which seeks to influence politics/policy-making • 7. Strategy: • Line of action chosen among available alternatives to interact with other actors or respond to context pressures  Important source of CA (and other) resources • 8. Leadership: • Capacity to choose a sound strategy (power for) in order to mobilize voluntary political participation, support and compliance at a very low cost (power over) Main source of CA resources • 9. Policy communities and networks • Actors’ configurations (who participate and how they interact) which try to influence policy in each sector, sub-sector, stage, and decision-making arena of the policy process.

9. WHO GOVERNS?

10. POWER-CENTRED TEORIES FROM (EC.) ACTION THEORIES: Group resources & strategy as key causes of policy change Actors as complex coalitions of political organizations and social groups steered by political leaders & enterpreneurs  FROM STRUCTURAL/POWER RESOURCES THEORIES: Social power resources as the main characteristic of actors; change with action Politics as an unequal, oligopolistic game in which stakeholders have permanent advantage Access and strength of stakechallengers & weakest social groups explains policy change Stakeholders must be divided  Who governs depends on who influences policy & who participates  access of socioP actors TOWARDS TWO MAIN THEORIES? ACTOR-CENTRED INSTITUTIONALISM • FROM (EC.) ACTION THEORIES: • Individual choice & strategy as key causes of policy change • Political actors as individuals  links with society reduced to basic resources ($, vote) + internal cohession assumed rather than investigated • Preferences as the main actors’ feature • Politics as a balanced game: interests compete on equal terms, none has permanent advantage • FROM INST./STATE-CENTRED THEORIES: • Institutional resources as actors’ main characteristic (also determining preferences) • Dominant actors (with formal, institutional political power) explain policy change  Focus on who governs only

11. Immergut, 1992

12. ACTOR-CENTRED INSTITUTIONALISM • FROM GAME THEORY (Scharpf, 2000)... • * State’s action strategies determine the degree of state autonomy & the probabilities of successfull state-led policy change  competition/cooperation are key to policy change: • Anticipatory (vs. reactive) strategies reinforce the autonomy of state actors from context and IGs pressures, (but are more costly & increase the risk of failure) • Consensual (vs. impositive) strategies take time and involve a compromise in preferences ( less chances of passing intended reform if controversial); but decrease political and implementation costs

13. POWER-CENTRED THEORIES • COMBINE POWER RESOURCES THEORY (structuralism + neomarxist IGs/PPs theory) WITH GAME THEORY  • Korpi 1989, Briggs 1961 • “The power resources approach does not, however, imply that social policy development is based on the oprganizational and political power of the working class and left parties alone”... • “Instead, the power resources approach [as reformulated into power-centred by Korpi] generates what in essence ammounts to a game theoretical perspective... Where the decisions made and the strategies adopted by each actor are seen as affected by actors’ perceptions of the relative power and probable choices of other actors” • “Because of their tenuous control over basic power resources, the autonomy of the state will be circunscribed”

14. Collective action resources Knowledge-based resources • Informal, experience-based • Formal, evidence-based • Internal cohesion • Coalition capacity • External support Financial resources Institutional resources • Formal political power • Formal organizational power • Ownership • ”Sponsorship” POWER RESOURCES:INFORMAL (social) & FORMAL (institutional) Adapted from Hughes-Tuohy 2003 and Hicks & Mishra 1993

15. THE POWER-CENTRED MODEL Contestability: access of new voters & parties Stake-challengers mobilization Electoral laws Economic cycle Soc.struct Realignements: coalitions, internal cohesion, support Policy change The welfare state Democratic institutions Policy subsystem institutions Constitution Stake-holders coalitions Competition: * Electoral & * Policy campaigns Adapted from Jenkings & Brents 1989. A political struggle interpretation of the origins of the American WS, ASR 54: 891-909

16. Sabatier’s policy subsystem and advocacy coalitions

17. FROM THESES TO HYPOTHESES A. Power-centred theory: HICKS & MISHRA 1993 • “ Welfare policy-making is a process in which actors, including some state ones, pursue their preferences in welfare policy, and do so on the basis of their political resources” • “We specify causes of welfare expansion as combinations of particular political resources and specific welfare orientations of political actors” B. Actor-centred institutionalism: HUBER et al. 1993 • “The state is esentially a set of institutions that processes pressures from economic interests and organized groups, and produce binding decisions on policy...Constitutions, in turn, lay down the nature of of these institutions... • Of paticular interest is [their impact on] the degree to which relatively small groups or special interests can block legislation, or conversely, the degree to which narrow parliamentary majorities can push through legislation”

18. ACTOR-C INST.: EVIDENCE • (State) actors and political parties are the main determinant of policy • Institutions increase or decrease their opportunities to influence policy EVIDENCE: Canada (NHI) vs the US (no NHI) in the 1960s • In the US as in Canada, the main advocate of NHI were small socialdemocratic parties territorially concentrated • In the US as in Canada, the majority of citizens strongly supported NHI in these states/provinces • In Canada, due to open political acess & strong federalism in HC, a tiny socialdemocratic party ruling in one province introduces NHI, demonstrating that can work with good effects outside Europe  this helps them convince the reluctant democratic party & public opinion to support it at national level • In the US, weak federalism impedes pro-WS minority parties to govern  no demonstration effects possible Maioni, 1997

19. CAUSES OF NHI: CANADA vs USA Maioni, 1997

20. ACTOR-C INST.: STATE STRATEGIES

21. POWER-C THEORY: EVIDENCE • CLINTON’S REFORM:See Quadagno 2004/Brodie 1996 and Hacker (1996) in JHPPL, 21, 1  Failure of reform due to... • 1. A weak pro-reform coalition... • Low political participation  weak stakechallengers... BECAUSE • Insufficient political leadership by the state  wrong coalition strategy + unclear/unconvincing policy model • Insufficient cohesiveness (& other resources) of state and societal actors • 2. A very strong anti-reform coalition... • Tight coalition of employers, insurers and professionals with high financial and knowledge resources • Successful double strategy of direct pressures to government + sophisticated media campaigns and social movements’ tactics to persuade public opinion

22. POWER-C THEORY: EVIDENCE Stakeholder analysis – Mapping actors’ resources and preferences. CLINTON’S REFORM 1993. Parliament Government Big bussiness Insurers’ Mass media Main parties Small bussiness Public opinion -Resources + Against Preferences For Professionals Trade Unions Social movements/NGOs Patient associations Consumer associations Peterson 1993, JHPPL

23. POWER-C THEORY: EVIDENCE Stakeholder analysis – Mapping actors’ resources and preferences. BEVERIDGE REFORM 1945 Parliament Government Main parties Professionals Big bussiness Trade Unions Public opinion -Resources + Mass media Against Preferences For Insurers’ (mainly not-for-profit) Small bussiness Industrial strikes Mass mobilization Based on Briggs 1969; Jacobs, 1992

24. WHO INFLUENCES POLICY?

25. WHO INFLUENCES POLICY? A. Power-centred theory • Who influences policy determines who govern • Who influences policy depends on... • Who participates (mobilization of weaker social groups) • How do participants interact (modify socioP actors´power resources) • The social structure (conditions both who participates & the initial stock of social power resources of socioP actors) B. Actor-centred institutionalism • Under strong political institutions, it is mainly state actors who influence policy  The question “who influences policy” becomes irrelevant • Under weak political institutions (power dispersion & veto points), the most powerful stakeholders (employers/professionals/TUs) coopt the state  those who influence policy (assumed), co-govern

26. WHO INFLUENCES POLICY? • Main predictors (Peterson, 1993 in JHPPL) • Acess of stakechallengers to the political system • Cooperation/competition of stakeholders & stakechallengers STAKE-CHALLENGERS ORGANIZED AND ACTIVE INTERACTIONS WITHIN & ACROSS BLOCKS

27. WHO INFLUENCES POLICY? FROM IRON TRIANGLES... ... TO POLICY NETWORKS & ADVOCACY COALITIONS? Doctors * Private * Public Doctors Knowedge Patients Media Policy experts State actors Lead? State/parties:CA, Institutional Public interest groups Policy enterpren. Industry Bussiness, Insurers, Pharma Bussiness: Financial, organizational Insurers: Financial Based in Peterson 1993 & 2003, H & R CH 6

28. WHO PARTICIPATES?

29. WHO PARTICIPATES? • 2) COLLECTIVE ACTION THEORY (Olson, Ostrom): Arguments  The decision to engage in collective action (=cooperate vs. free- ride) depends on individuals’ balance of costs/benefits • * Concentrated costs: time, effort, money, risk, information • * Collective, dispersed benefits: a) individual (marginal) impact small; b) difficult to exclude non-participants (free-riding)  As all public goods, collective action does not pay off  On voluntary basis, it works best only in groups which are: - A. Small (homogeneity of interests, frequent interaction, social control) - B. Intense: strong political preferences  Otherwise requires positive (e.g. rewarding social interaction) & negative incentives (e.g. Compulsory participation) introduced by the state or group leaders

30. WHO PARTICIPATES? • Collective action experiments (Ostrom, 2000): • - Most people (70%) will cooperate rather than free-ride when there is reasonable certainty that personal costs will be lower than benefits • - A majority of people (40%-60%) will participate in collective action (‘cooperate’) under uncertainty on whether personal costs will be higher than benefits • A minority of people (20%-30%) will cooperate even when they are certain that personal costs will be higher than benefits • Evidence on political participation (Topf, 1998) • - Citizens can be classified in activists, voters and inactive; • - Participants (activists + voters) tend to be richer, better educated and older than non-participants, although differences are narrowing in most W.Europe • - Between 80% and 40% of the population votes. Stable during 1960-90 • - Across W.European countries, activists represent between 75% (Scandinavia) and 32% (Southern Europe) in 1990; and tend to be young and female left-wingers • The interest in conventional (voting, pol.parties, interest groups) politics is declining • The class cleavage is shifting towards state/market involvement, or turning ethnic/religious

31. WHO PARTICIPATES? 2) OTHER THEORIES (1., 2. & 3. Power-C; 4. Actor-C inst.):  The decision to engage in collective action depends on • 1. the intensity of political conflict across social cleaveages (class/income, religion/values, community/ethnia), ideologies and political issues (social structuralism) and ... • 2. the extent to which there are political elites/organizations who actively mobilize (and represent) their constituencies (power resources theories  actor/action); • 3. ... which in turns depends on the extent to which state policies grants equal political & social rights to under/priviledged groups (policy feedbacks) • 4. the openess of democratic institutions to direct political participation (institutionalism), eg voting regulations, neocorporatism, popular legislative initiative, referendum NOTE: Olson’s thesis are compatible with all the above

32. WHO PARTICIPATES? • The decision to participate depends on citizens´ perception of • 1. Their subjective political competence (to what extent can they influence policy if they mobilize)  do they have enough (CA + knowledge) resources? + will resources be effective enough?  importance given by the state to CA vs. other (financial, organizational, institutional) power resources • 2. Legitimacy & costs of political mobilization in terms of state repression of political mobilization & social sanctions from prevailng political culture  Is it acceptable to break rules if they are unjust in order to change them? SUBJECTIVE POLITICAL COMPETENCE YESNO LOW LEGITIMACY & COSTS OF MOB. HIGH

33. WHO PARTICIPATES? WHY? • Subjective political competence/efficacy: Can you do something about an unjust or harmful local regulation or national law? • Legitimacy of breaking rules to change them: Do you think there are times in which people might be justified to disobey laws to protest things they find very unjust or wrong?

34. POLICY IMPLICATIONS • New institutionalism, path sependence: • Institutions do not change, hence once they are established big policy turns are unlikely  Historical determinism: countries are prisioners of history (and individuals of their early socialization experiences/the prevailing social norms) • Actor-centred institutionalism: debate on • Immergut: Changing formal political institutions towards further concentration of power increases the likelihood of policy change, even if powerful opposed interests • Maioni (with Lijphart): Institutions which disperse power increase access of minority political parties in government and hence the likelihood of policy change • Power-centred theories: • Actors with less (financial or institutional) power resources can influence policy through coalition strategies and political leadership • Policy change requires divided stakeholders & united stakechallengers