Nondecision making and inertia in Portuguese health policy

Despite there having been a positive context for initiating health care reforms in Portugal in the past fifteen years (accompanied by political consensus on the nature of the structural problems within the health care system), there has been a lack of reform initiatives. We use a process-based framework to show how institutional arrangements have influenced Portuguese health care reform. Evidence is presented to demonstrate inertia and nondecision making in three critical areas of Portuguese health policy: clarifying the public-private mix in coverage and provision, creating financial incentives and motivation for human resources, and introducing changes in the pharmaceutical market. Several factors seem to explain these processes, namely, problems in the balance of power within the political system, which have contributed to a lack of proper policy discussion; a lack of pluralism in the formation of health care policies (with low participation from citizens and high mobilization among structural interest groups); and the low priority of health care in public sector reforms. Portuguese politicians should be aware of the pitfalls of the current political system that constrain participatory arrangements and pluralism in policy making. In order to pursue health care reform, future governments will need to counterbalance the strong influence of structural interest groups.     

VAT Revenues in the Russian Federation: The Role of Tax Administration in Their Decline

Value added taxes (VATs) are important major revenue sources worldwide, yet keeping these taxes as easy to administer as possible is often overlooked. A poorly administered VAT raises less revenue than possible and can change the very nature of the tax, resulting in unintended economic distortions. This article analyzes the experience with the VAT in the Russian Federation and provides evidence that poor tax administration both contributed to the decline of VAT revenues beginning in 1993 and continues to hamper VAT revenue collection today. Administrative issues must not be ignored when implementing a consumption-based tax like the VAT.     

A Theory of International Conflict Management and Sanctioning

In this paper we analyze sanctioning policies in internationallaw. We develop a model of international military conflictwhere the conflicting countries can be a target ofinternational sanctions. These sanctions constitute anequilibrium outcome of an international political market forsanctions, where different countries trade politicalinfluence. We show that the level of sanctions in equilibriumis strictly positive but limited, in the sense that highersanctions would exacerbate the military conflict, not reduceit. We then propose an alternative interpretation to theperceived lack of effectiveness of international sanctions, byshowing that the problem might not be one of undersanctioningbut of oversanctioning.     

Non-Governmental Organizations (NGOs) and Politics in the Developing World

The proliferation of non-governmental organizations (NGOs) in the developing, as well as the developed, world, has triggered an 'associational revolution'. Political scientists, however, have made a relatively minor contribution to the contemporary NGO literature which has evolved since the mid-1980s. This article examines some of the main political themes addressed in the NGO literature, as well as related themes in other political studies. NGOs, the article argues, make significant contributions to political life and to political change in developing countries, revealing a fertile, and hitherto neglected, research agenda.     

Mandating Social Change: The Business Struggle Over National Health Reform

This article explores the conditions under which business managers endorse human resource investment policy drawing from the recent national health reform episode. In order to generate corporate support, a business community must develop corporate policy capacity, or the ability to grasp complicated social issues and to act in support of this social agenda. Corporate support is also influenced by the business–related strategies of government leaders who can encourage businesses to organize around legislative issues. The bid for national health reform met neither condition. Corporate policy capacity was inadequate to sustaining business support for health reform at the point of translating general corporate anxiety into specific legislation. Because U.S. business groups are weak, fragmented, and compete for members, they tend to cater to strong, vocal minorities and are often unable to act on majority positions. In health reform although a majority of business groups' members wanted reform, minority objections prevailed. In addition, where the Clinton administration's business mobilization efforts were complicated by its campaign for mass support, the Republicans organized a formidable corporate lobby against the bill.     

‘Bringing the state back in’: A political economy analysis of Portuguese immigration policy

Southern European states are recurrently represented as ‘safe havens’ for irregular immigration in face of powerless national governments. Drawing from an interdisciplinary approach combining the domestic politics approach and the political economy of migration, this investigation explores the effectiveness of the Portuguese policy towards labour and irregular inflows during the 1990s and the 2000s. Against the increasing exclusion of politics and national governments in immigration studies, this research focuses on the agency of the Portuguese state. This article associates the intensity of irregular inflows with the covert expansive approach towards immigration adopted by the Portuguese state, driven by economic objectives.