Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-10T15:53:14.780Z Has data issue: false hasContentIssue false

Explaining accountability for public policies: an fsQCA analysis of health policy in Spain

Published online by Cambridge University Press:  14 December 2015

Ixchel Pérez Durán*
Affiliation:
Juan de la Cierva Postdoctoral Research Fellow, Institut Barcelona d’Estudis Internacionals (IBEI), Barcelona, Spain
Jorge Rodríguez Menés
Affiliation:
Serra Hunter Associate Professor, Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
*

Abstract

Which conditions foster accountability for health policy implementation in Spain’s 17 regional governments? We analyze five conditions: private management of health services, political salience of health policies, governments’ left ideological position, strong presence of non-statewide parties, and minority governments. We use fuzzy-set Qualitative Comparative Analysis (fsQCA) to identify how necessary and/or sufficient these conditions are (alone or in combination) to foster accountability. We find that there is no single recipe to ‘cook’ accountability. Three conditions appear to be ‘quasi-necessary’ but must be combined with others to foster accountability, thus defining three routes to accountability. The implications of the findings are discussed in light of current debates on the effects of decentralization, left-right ideologies, and privatization, on accountability for public policies.

Type
Research Article
Copyright
© European Consortium for Political Research 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

The two authors contributed equally to the article and are listed alphabetically.

References

Agranoff, R (1993), ‘Inter‐governmental politics and policy: building federal arrangements in Spain’, Regional & Federal Studies 3(2): 128.Google Scholar
Aguilar, P. and Sánchez-Cuenca, I. (2007), ‘¿Gestión o representación? Los determinantes del voto en contextos políticos complejos (Performance or representation? The determinants of voting in complex political contexts)’, Revista Española de Investigaciones Sociológicas 117: 6186.Google Scholar
Anderson, P (1974), Lineages of the Absolutist State, London: New Left Books.Google Scholar
Bakker, R., de Vries, C., Edwards, E., Hooge, L., Jolly, S., Marks, G., Polk, J., Rovny, J., Steenbergen, M. and Vachudova, M. (2015), ‘Measuring party positions in Europe: the Chapel Hill expert survey trend file, 1999–2010’, Party Politics 21(1): 143152.Google Scholar
Bardach, E (1977), The Implementation Game: What Happens After a Bill Becomes a Law, Cambridge: MIT Press.Google Scholar
Barrio, A., Rodríguez, J., Baras, M. and Barberà, O. (2010), ‘Partidos de ámbito no estatal y gobernabilidad multinivel: el caso de España (1977-2008)’. WP No. 291, Institut de Ciències Polítiques i Socials, Barcelona.Google Scholar
Bevan, G., Connolly, S. and Mays, N (2015), ‘The United Kingdom’, in K. Fierlbeck and H. Palley (eds), Comparative Health Care Federalism, Farnham, UK: Ashgate, pp. 7993.Google Scholar
Bovens, M (2007), ‘Analysing and assessing accountability. A conceptual framework’, European Law Journal 13(4): 447468.CrossRefGoogle Scholar
Bovens, M (2010), ‘Two concepts of accountability: accountability as a virtue and as a mechanism’, West European Politics 33(5): 946967.Google Scholar
Brenan, G (1990), The Spanish Labyrinth; an Account of the Social and Political Background of the Civil War, Cambridge: Cambridge University Press.Google Scholar
Brandsma, G.J. and Schillemans, T. (2013), ‘The accountability cube: measuring accountability’, Journal for Public Administration Research and Theory 23(3): 125.CrossRefGoogle Scholar
Busuioc, M (2012), ‘European agencies and their boards: promises and pitfalls of accountability beyond design’, Journal of European Public Policy 19(5): 719736.Google Scholar
Busuioc, M (2013), European Agencies: Law and Practices of Accountability, Oxford: Oxford University Press.Google Scholar
Carr, R (1982), Spain. 1808-1975, New York, NY: Oxford University Press.Google Scholar
Díez Medrano, J (1995), Divided Nations: Class, Politics and Nationalism in the Basque Country and Catalonia, Ithaca, NY: Cornell University Press.Google Scholar
Donahue, J.D. and Zeckhauser, R.J. (2008), ‘Public-private collaboration’, in R.E. Goodin, M. Rein and M. Moran (eds), The Oxford Handbook of Public Policy, Oxford: Oxford University Press, pp. 496525.Google Scholar
Dubnick, M.J. and Frederickson, H.G. (2009), ‘Accountable agents: federal performance measurement and third-party government’, Journal of Public Administration Research and Theory 20(Suppl 1): i143i159.Google Scholar
Duckett, S (2015), ‘Australia’, in K. Fierlbeck and H. Palley (eds), Comparative Health Care Federalism, Farnham, UK: Ashgate, pp. 123138.Google Scholar
Egeberg, M. and Trondal, J. (2011), ‘EU-level agencies: new executive centre formation or vehicles for national control?’, Journal of European Public Policy 18(6): 868887.Google Scholar
Fierlbeck, K. and Palley, H. (2015), ‘Canada’, in K. Fierlbeck and H. Palley (eds), Comparative Health Care Federalism, Farnham, UK: Ashgate, pp. 107121.Google Scholar
Fisher, S.D. and Hobolt, S.B. (2010), ‘Coalition government and electoral accountability’, Electoral Studies 29(3): 358369.CrossRefGoogle Scholar
Godbout, J.F. and Høyland, B. (2009), ‘Legislative coalitions and minority governments in Canada’. Paper presented at the Canadian Political Science Association Meeting, May 29, Ottawa.Google Scholar
Grant, R.W. and Keohane, R.O. (2005), ‘Accountability and abuses of power in world politics’, American Political Science Review 99(1): 2943.CrossRefGoogle Scholar
Grimmelikhuijsen, S. and Welch, E. (2012), ‘Developing and testing a theoretical framework for computer-mediated transparency of local governments’, Public Administration Review 72(4): 562571.Google Scholar
Hanretty, C. and Koop, C. (2012), ‘Measuring the formal independence of regulatory agencies’, Journal of European Public Policy 19(2): 198216.Google Scholar
Hodge, G.A and Coghill, K. (2007), ‘Accountability in the privatized state’, Governance 20(4): 675702.Google Scholar
Hood, C (1995), ‘The “new public management” in the 1980s: variations on a theme’, Accounting, Organizations and Society 20(2): 93109.Google Scholar
Howlett, M (2011), Designing Public Policies. Principles and Instruments, New York, NY: Routledge.Google Scholar
Klenk, T (2011), ‘Ownership change and the rise of a for-profit hospital industry in Germany’, Policy Studies 32(3): 263275.Google Scholar
Klenk, T. and Pieper, J. (2013), ‘Accountability in a privatized welfare state. The case of the German hospital market’, Administration and Society 45(3): 326356.Google Scholar
Koop, C (2011), ‘Explaining the accountability of independent agencies: the importance of political salience’, Journal Public Policy 31(2): 209234.Google Scholar
Koop, C (2014), ‘Theorizing and explaining voluntary accountability’, Public Administration 92(3): 565581.Google Scholar
Lago, S. and Cantarero, D. (2012), ‘‘Decomposing the determinants of health care expenditure: the case of Spain’, European Journal of Health Economics 13(1): 1927.Google Scholar
Laitin, D (1998), Identity in Formation: The Russian-Speaking Populations in the Near Abroad, Vol. 22 Ithaca, NY: Cornell University Press.Google Scholar
León, S (2011), ‘Who is responsible for what? Clarity of responsibilities in multilevel states: the case of Spain’, European Journal of Political Research 50(1): 80109.Google Scholar
León, S (2012), ‘How do citizens attribute responsibilities in multilevel states? Learning, biases and asymmetric federalism. Evidence from Spain’, Electoral Studies 31(1): 120130.CrossRefGoogle Scholar
Lindberg, S.I (2013), ‘Mapping accountability: core concept and subtypes’, International Review of Administrative Sciences 79(2): 202226.CrossRefGoogle Scholar
Linz, J (1978), The Breakdown of Democratic Regimes: Crisis, Breakdown and Reequilibrium, Baltimore, MD: John Hopkins University.Google Scholar
López-Casasnovas, G. and Saez, M. (2007), ‘A multilevel analysis on the determinants of regional health care expenditure: a note’, The European Journal of Health Economics 8(1): 5965.Google Scholar
Maggetti, M (2012), ‘The media accountability of independent regulatory agencies’, European Political Science Review 4(3): 385408.CrossRefGoogle Scholar
McElroy, G. and Benoit, K. (2011), ‘Policy positioning in the European parliament’, European Union Politics 13(1): 150167.Google Scholar
Minow, M (2003), ‘Public and private partnerships: accounting for the new religion’, Harvard Law Review 116(5): 12291270.Google Scholar
Moreno, L (2002), ‘Decentralization in Spain’, Regional Studies 36(4): 399408.Google Scholar
Mulgan, R (2000), ‘“Accountability”: an ever expanding concept?’, Public Administration 78: 555573.Google Scholar
Müller, W (2008), ‘Governments and bureaucracies’’, in D. Caramani (ed.), Comparative Politics, Oxford: Oxford University Press, pp. 189216.Google Scholar
Noël, A (2013), ‘¿ Café para todos? Homogeneity, difference, and Canadian federalism’, in A., López-Basaguren and S. Epifanio (eds), The Ways of Federalism in Western Countries and the Horizons of Territorial Autonomy in Spain, Vol. 1 Berlin and Heidelberg: Springer, pp. 359374.CrossRefGoogle Scholar
Page, E.C (2010), ‘Accountability as a bureaucratic minefield: lessons from a comparative study’, West European Politics 33(5): 10101029.Google Scholar
Pallarés, F. and Keating, M. (2003), ‘Multilevel electoral competition: regional elections and party systems in Spain’, European Urban and Regional Studies 10(3): 239256.CrossRefGoogle Scholar
Pallarés, F., Montero, J.R. and Llera, F. (1997), ‘Non state-wide parties in Spain: an attitudinal study of nationalism and regionalism’, Publius 27: 135169.Google Scholar
Papadopoulos, Y (2010), ‘Accountability and multilevel governance: more accountability, less democracy?’, West European Politics 33(5): 10301049.CrossRefGoogle Scholar
Pérez Durán, I (2015), ‘Assessing formal accountability for public policies: the case of health policy in Spain’, International Review of Administrative Sciences, doi:10.1177/0020852314565999.Google Scholar
Pollitt, C (2005), ‘Decentralization. A central concept in contemporary public management’, in E. Ferlie, L.E. Lynn and C. Pollitt (eds), The Oxford Handbook of Public Management, Oxford: Oxford University Press, pp. 371394.Google Scholar
Pressman, J.L. and Wildavsky, A. (1973), Implementation: How Great Expectations in Washington are Dashed in Oakland, Los Angeles, CA: University of California Press.Google Scholar
Rabovsky, T.M (2012), ‘Accountability in higher education: exploring impacts on state budgets and institutional spending patterns’, Journal of Public Administration Research and Theory 22(4): 675700.Google Scholar
Ragin, C.C (1987), The Comparative Method: Moving Beyond Qualitative and Quantitative Strategies, Berkeley, CA: University of California Press.Google Scholar
Ragin, C.C (2000), Fuzzy Set Social Sciences, Chicago, IL and London: The University of Chicago Press.Google Scholar
Ragin, C.C (2008a), Redesigning Social Inquiry. Fuzzy Sets and Beyond, Chicago, IL and London: The University of Chicago Press.CrossRefGoogle Scholar
Ragin, C.C (2008b), User’s Guide to Fuzzy-Set/Qualitative Comparative Analysis, Tucson, AZ: Department of Sociology, University of Arizona.Google Scholar
Rainey, H.G. and Chun, Y.H. (2005), ‘Public and private management compared’, in E. Ferlie, L.E. Lynn and C. Pollitt (eds), The Oxford Handbook of Public Management, Oxford: Oxford University Press, pp. 72102.Google Scholar
Rico, A. and Costa, J. (2005), ‘Power rather than path dependency? The dynamics of institutional change under health care federalism’, Journal of Health Politics, Policy and Law 30(1–2): 231252.CrossRefGoogle ScholarPubMed
Ringquist, E.J., Worsham, J. and Eisner, M.A. (2003), ‘Salience, complexity , and the legislative direction of regulatory bureaucracies’, Journal of Public Administration, Research and Theory 13(2): 141164.CrossRefGoogle Scholar
Rodden, J (2004), ‘Comparative federalism and decentralization: on meaning and measurement’, Comparative Politics 36(4): 481500.CrossRefGoogle Scholar
Rondinelli, D.A., Nellis, J.R. and Cheema, G.S. (1983), ‘Decentralization in developing countries’. Staff Working Paper No. 581, Washington, D.C.: World Bank.Google Scholar
Rothschild, J (1981), Ethnopolitics. A Conceptual Framework, New York, NY: Columbia University Press.Google Scholar
Sabatier, P.A (1999), Theories of the Public Policy Process, Boulder, CO: Westview Press.Google Scholar
Schneider, C.Q. and Wagemann, C. (2010), ‘Standards of good practice in qualitative comparative analysis(QCA) and fuzzy-sets’, Comparative Sociology 9(3): 397418.Google Scholar
Schneider, C.Q. and Wagemann, C. (2012), Set-Theoretic Methods for the Social Sciences, Cambridge: Cambridge University Press.Google Scholar
Soroka, S., Maioni, A. and Martin, P. (2013), ‘What moves public opinion on health care? Individual experiences, system performance, and media framing’, Journal of Health Politics, Policy and Law 38(5): 893920.Google Scholar
Stiglitz, J (2000), Economics of the Public Sector, New York, NY: W.W. Norton.Google Scholar
Stinchcombe, A (2001), When Formality Works: Authority and Abstraction in Law and Organizations, Chicago, IL: University of Chicago Press.Google Scholar
Strøm, K (1990), Minority Government and Majority Rule, Cambridge: Cambridge University Press.Google Scholar
Sulitzeanu-Kenan, R (2010), ‘Reflection in the shadow of blame: when do politicians appoint commissions of inquiry?’, British Journal of Political Science 40(3): 613634.Google Scholar
Trebilcock, M.J. and Iacobucci, E.M. (2003), ‘Privatization and accountability’, Harvard Law Review 115(5): 14221453.Google Scholar
Vis, B. (2012), ‘The comparative advantages of fsQCA and regression analysis for moderately large-N analysis’, Sociological Methods & Research 41: 168198.Google Scholar
Vrangbæk, K (2007), ‘Key factors in assessing decentralization and recentralization in health systems’, in Saltman, R.B., Bankauskaite, V. and Vrangbæk, K (eds), Decentralization in Health Care, Maidenhead: Open University Press, pp. 6376.Google Scholar
Willems, T (2014), ‘Democratic accountability in public-private partnerships: the curious case of Flemish school infrastructure’, Public Administration 92(2): 340358.Google Scholar
Wlezien, C (1995), ‘The public as thermostat: dynamics of preferences for spending’, American Journal of Political Science 39(4): 9811000.Google Scholar
Wlezien, C (2005), ‘The salience of political issues: the problem with “most important problem”’, Electoral Studies 24: 555579.Google Scholar
Supplementary material: File

Durán and Rodríguez Menés supplementary material

Durán and Rodríguez Menés supplementary material 1

Download Durán and Rodríguez Menés supplementary material(File)
File 36.9 KB
Supplementary material: File

Durán and Rodríguez Menés supplementary material

Table A1

Download Durán and Rodríguez Menés supplementary material(File)
File 41.5 KB