The dilemmas of incrementalism: logical and political constraints in the design of health insurance reforms.

Health care reform became a premier issue on the U.S. policy agenda in the 1990s. While the comprehensive proposal put forth by President Clinton failed, states and the federal government successfully pursued a variety of lesser initiatives. This article focuses on a set of reforms intended to make private health insurance more accessible and affordable to individuals and workers in small firms. It outlines the key arguments made by experts to justify stronger regulation of health insurance and the options and difficult tradeoffs that must be considered in policy design. It then examines the scope and strength of legislation adopted by 45 states and the federal government from 1990 to 1996. The substantial variation in state policies demonstrates that even though insurance market reform was the one issue that commanded nearly universal support in the health care debate, few design features were universally accepted by those who crafted the reforms. The article concludes by assessing the pattern of state and federal action. The reforms represent some progress on nominal access to insurance but little progress on the affordability of insurance for individuals and small groups. Few of the reforms present a serious challenge to existing practices and interests of the insurance industry. This pattern of policy design reflects the logical and political constraints of incrementalism. In a system where insurance coverage is voluntary, changes to increase access for one group tend to increase costs and thereby decrease access for another segment of the population. In addition, because incremental reforms will not attract sustained attention and support from the general public, it is politically difficult to impose substantial new regulation on a powerful industry.     

Economic crisis, party system change, and the dynamics of class voting in Venezuela, 1973–2003

The breakdown of the old catch-all party system in Venezuela, and the sudden rise to power of leftist former coup leader Hugo Chávez provides an instructive case study to examine the sources of party system change, the rise of populism and the politicisation of class. Using nationally representative survey data this paper analyses different models of voting behaviour over time, and examines the extent to which the determinants of electoral choice have changed. It argues that although economic crises during the 1990s undermined support for the existing parties, it did not create a politically salient class-based response. Rather, it created the electoral space for new actors to enter the political stage and articulate new populist issue dimensions. Explanations for the politicisation of social cleavages in Venezuela can therefore best be understood in terms of ‘top-down’ approaches which emphasises the role of political agency in reshaping and re-crafting political identities, rather than more ‘bottom-up’ factors which emphasise the demands that originate within the electorate.     

The coordinate plane of global governance

The ‘coordinate plane of global governance’ developed in this paper describes the trade-off between static gains and dynamic losses associated with international policy harmonization. A simple model illustrates how potential gains result from producing positive international spill-overs, whereas potential losses come from restricted systems competition between national policy regimes. The solution to this model allows identifying the cut-off level between policies suitable for global harmonization and policies which should better not be centralized. An application of the concept to selected policy fields illustrates its relevance for decision-making on global governance.

Global Britain and the Narrative of Empire

Since 2016, the UK government has outlined plans for ‘Global Britain’ as a framework for post‐Brexit foreign policy. Some criticise the idea as a vision of ‘Empire 2.0’, but it is rarely made clear exactly what form it takes or what its wider political implications are. This article argues that Global Britain constitutes not just an idea or a slogan, but a foreign policy narrative and, more specifically, the narrative of empire. Indeed, to appear reasonable its grand ambitions require pre‐existing knowledges of past imperial ‘successes’ and accepting images of empire among the British public. Yet Global Britain lacks efficacy: as a domestic rather than an international narrative, by being inherently regressive in its worldview, and for contradicting the preferences of international partners on which the UK heavily relies. These narrative flaws, it is argued, make Global Britain an actively problematic, rather than merely ineffective, component of UK foreign policy.     

Sorting Out Sortition: A Perspective on the Random Selection of Political Officers

The central argument of this article is that it is possible to identify one major or primary potential that sortition brings to the political community when it is used to select office holders. This is to be found when sortition is used in such a way as to maximise its most essential feature – its arationality – and where such an application has the most significant and positive impact on the political process and the political community. In such applications the advantages of using an arational process can be seen as outweighing its disadvantages. In political practice – especially in a republican context – this primary political potential is the ability of sortition to protect the public process of selection from subversion by those who might wish to use it for their own private or partisan ends. This helps to defend the polity from those seeking to exercise unconstitutional or arbitrary power – either in the form of a single tyrant or of factions vying for partisan control. In addition, sortition can produce a series of secondary benefits to the republican polity: the polity can be understood as impartial, the threshold to citizen participation can be lowered and the model of the independent citizen encouraged. These benefits, however, can be seen as deriving from initial protection of the process of selection from manipulation – a quality of lot which is present whatever the motivation of those instigating a particular lottery scheme. Although the political use of lot cannot be confined to the protection of open government, its potential to limit the power of individuals or covert groupings makes it naturally commensurate with this role.