Fixing Federal Faults. Complementary Member State Policies in Swiss Health Care Policy

This article aims to understand what makes member states complement federal healthcare policy beyond the instruments planned by federal policy. We employ a Multiple Streams approach to study how Swiss member states use their discretion in order to complement federal healthcare regulation with the ai...

Full description

Saved in:
Bibliographic Details
Main Authors: Fritz Sager, Christian Rüefli, Eva Thomann
Format: Article
Language:English
Published: OpenEdition 2019-10-01
Series:International Review of Public Policy
Subjects:
Online Access:https://journals.openedition.org/irpp/426
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841551192109350912
author Fritz Sager
Christian Rüefli
Eva Thomann
author_facet Fritz Sager
Christian Rüefli
Eva Thomann
author_sort Fritz Sager
collection DOAJ
description This article aims to understand what makes member states complement federal healthcare policy beyond the instruments planned by federal policy. We employ a Multiple Streams approach to study how Swiss member states use their discretion in order to complement federal healthcare regulation with the aim of decreasing outpatient healthcare expenditures at the cantonal level. Based on a written survey in the Swiss cantons, we perform a Fuzzy Set Qualitative Comparative Analysis (fsQCA), which places a keen emphasis on complex patterns. The method identifies what combinations of determinants make it particularly likely that a canton opts for complementary policy activity. Several configurations prove to foster such activity. While this is important, it is also important to pay attention to the constellations that precisely do not foster complementary policy activity. Our analysis of the cantonal choices on governing outpatient healthcare reveals that party politics in the executive and/or the public administration play a major role in this task, whereas neither organized interests within the medical profession nor individual policy entrepreneurs are crucial. Federalist systems offer opportunities for policy innovations the federal level ultimately may benefit from.
format Article
id doaj-art-b5b6911e44a9481e9b0bdd963bb64349
institution Kabale University
issn 2679-3873
2706-6274
language English
publishDate 2019-10-01
publisher OpenEdition
record_format Article
series International Review of Public Policy
spelling doaj-art-b5b6911e44a9481e9b0bdd963bb643492025-01-09T16:26:05ZengOpenEditionInternational Review of Public Policy2679-38732706-62742019-10-01114717210.4000/irpp.426Fixing Federal Faults. Complementary Member State Policies in Swiss Health Care PolicyFritz SagerChristian RüefliEva ThomannThis article aims to understand what makes member states complement federal healthcare policy beyond the instruments planned by federal policy. We employ a Multiple Streams approach to study how Swiss member states use their discretion in order to complement federal healthcare regulation with the aim of decreasing outpatient healthcare expenditures at the cantonal level. Based on a written survey in the Swiss cantons, we perform a Fuzzy Set Qualitative Comparative Analysis (fsQCA), which places a keen emphasis on complex patterns. The method identifies what combinations of determinants make it particularly likely that a canton opts for complementary policy activity. Several configurations prove to foster such activity. While this is important, it is also important to pay attention to the constellations that precisely do not foster complementary policy activity. Our analysis of the cantonal choices on governing outpatient healthcare reveals that party politics in the executive and/or the public administration play a major role in this task, whereas neither organized interests within the medical profession nor individual policy entrepreneurs are crucial. Federalist systems offer opportunities for policy innovations the federal level ultimately may benefit from.https://journals.openedition.org/irpp/426implementationhealth policyfederalismoutpatient healthcaremember statesvertical federal relations
spellingShingle Fritz Sager
Christian Rüefli
Eva Thomann
Fixing Federal Faults. Complementary Member State Policies in Swiss Health Care Policy
International Review of Public Policy
implementation
health policy
federalism
outpatient healthcare
member states
vertical federal relations
title Fixing Federal Faults. Complementary Member State Policies in Swiss Health Care Policy
title_full Fixing Federal Faults. Complementary Member State Policies in Swiss Health Care Policy
title_fullStr Fixing Federal Faults. Complementary Member State Policies in Swiss Health Care Policy
title_full_unstemmed Fixing Federal Faults. Complementary Member State Policies in Swiss Health Care Policy
title_short Fixing Federal Faults. Complementary Member State Policies in Swiss Health Care Policy
title_sort fixing federal faults complementary member state policies in swiss health care policy
topic implementation
health policy
federalism
outpatient healthcare
member states
vertical federal relations
url https://journals.openedition.org/irpp/426
work_keys_str_mv AT fritzsager fixingfederalfaultscomplementarymemberstatepoliciesinswisshealthcarepolicy
AT christianruefli fixingfederalfaultscomplementarymemberstatepoliciesinswisshealthcarepolicy
AT evathomann fixingfederalfaultscomplementarymemberstatepoliciesinswisshealthcarepolicy