The Politics of Health Policy in Eastern and Southern Europe
abstract | Governments shape policies that restrict or enable access to health services, thereby directly impacting the health and financial livelihoods of their citizens. I build a measure of health decommodification to assess changes in health systems with regards to individual risks when seeking care. The measure is used to addresses the question of the circumstances under which governments retrench or expand access to health care. To answer this question, I use a set-theoretic multi-method research design to understand the politics of health reform in Eastern and Southern European states. My theoretical framework emphasizes the importance of government characteristics and the ways in which they interact with institutional and structural factors. Government stability, the type of linkages between parties and voters, and the political color of governments form the political factors, while the number of institutional veto points, the balance of the health budget, and budget deficits comprise the institutional and structural factors. The study combines case study comparisons and fuzzy set Qualitative Comparative Analysis (fsQCA). The two main case studies, the Czech Republic and Bulgaria, show how health partisanship is different than other polices. I argue that health policy is different because it enjoys broader support among voters than other welfare policies. Programmatic parties pick up on these cues and expand or refrain from retrenching healthcare as an electoral strategy. Parties with less programmatic linkages to voters choose to ignore these preferences and restrict access to healthcare.
bio | Alexandru Moise is a PhD fellow at Central European University, Budapest.