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Health system reform and path-dependency: how ideas constrained change in South Africa’s national health insurance policy process 医疗系统改革与路径依赖:观念如何制约南非国家医疗保险政策进程的变革
IF 5.3 3区 管理学 Q1 PUBLIC ADMINISTRATION Pub Date : 2024-07-18 DOI: 10.1007/s11077-024-09541-w
Eleanor Beth Whyle, Jill Olivier

Path-dependency theory says that complex systems, such as health systems, are shaped by prior conditions and decisions, and are resistant to change. As a result, major policy changes, such as health system reform, are often only possible in policy windows—moments of transition or contextual crisis that re-balance social power dynamics and enable the consideration of new policy ideas. However, even in policy windows there can be resistance to change. In this paper, we consider the role of ideas in constraining change. We draw on political science theory on the dynamic relationship between foreground ideas (policy programmes and frames) and background ideas (deeply held collective cognitive and normative beliefs) to better understand how ideas exert influence independently of the contextual conditions that give rise to them or the actors that espouse them. To do so, we examine two apparent policy windows in the South African National Health Insurance policy process. The analysis reveals how ideas can become institutionalised in organisations and procedures (such as policy instruments or provider networks), and in intangible cultural norms—becoming hegemonic and uncontested ideas that shape the attitudes and perspectives of policy actors. In this way, ideas operate as independent variables, constraining change across policy windows. While health policy analysts increasingly recognise the influence of ideational variables in policy processes, they tend to conceptualise ideas as tools actors wield to drive change. This analysis reveals the importance of considering ideas (values, norms, and beliefs) as persistent features of the policy-making context that constrain actors.

路径依赖理论认为,复杂的系统,如卫生系统,是由先前的条件和决定形成的,对变革具有阻力。因此,重大的政策变革,如卫生系统改革,往往只有在政策窗口期才有可能--过渡或背景危机的时刻,可以重新平衡社会权力动态,使新的政策理念得到考虑。然而,即使在政策窗口期,变革也会遇到阻力。在本文中,我们将探讨思想在制约变革中的作用。我们借鉴了政治学中关于前景理念(政策方案和框架)与背景理念(根深蒂固的集体认知和规范信仰)之间动态关系的理论,以更好地理解理念是如何独立于产生理念的环境条件或支持理念的行动者而施加影响的。为此,我们研究了南非国家医疗保险政策过程中两个明显的政策窗口。分析揭示了观念如何在组织和程序(如政策工具或提供者网络)以及无形的文化规范中制度化--成为霸权和无争议的观念,塑造政策参与者的态度和观点。通过这种方式,观念作为独立变量发挥作用,制约着整个政策窗口的变化。虽然卫生政策分析师越来越认识到意识形态变量在政策过程中的影响,但他们倾向于将意识形态概念化为行动者推动变革的工具。这项分析揭示了将观念(价值观、规范和信仰)视为制约行动者的决策环境的持久特征的重要性。
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引用次数: 0
Keep me posted, but don’t stress me out: how the positive effect of social networking services on civil servants’ information use and political capacities can be attenuated by social media stress 随时向我通报情况,但不要给我压力:社交网络服务对公务员信息使用和政治能力的积极影响如何因社交媒体压力而减弱
IF 5.3 3区 管理学 Q1 PUBLIC ADMINISTRATION Pub Date : 2024-07-18 DOI: 10.1007/s11077-024-09539-4
Camilla Wanckel

Public policy and administration debates typically assume that ICT tools, including social networking services (SNS), increase the amount of information that is communicated and thus harnessed for policymaking processes. At the same time, behavioral approaches point to the potentially detrimental effects of social media stress resulting from an overexposure to SNS. Because systematic research on the individual-level effects of SNS in policy formulation is rare, this paper explores the effect of SNS on the use of policy-relevant information and, thus, on individual political capacities. A moderated mediation analysis was performed based on survey data from central ministerial bureaucracies in Germany, Italy, and Norway, considering not only the amount of information utilized in legislative drafting but also the variability and concentration of the information sources. The results indicate that SNS positively relate to policy officials’ information use, which, in turn, increases their self-reported political capacities. However, the positive relationship between SNS and both the amount and the variability of information use was found to be diminished when levels of social media stress are high rather than low. The conclusions discuss the implications for civil servants and policymaking.

公共政策和行政管理辩论通常认为,包括社交网络服务(SNS)在内的信息与传播技术工具增加了信息传播量,从而有助于决策过程。与此同时,行为学方法指出,过度接触 SNS 可能会对社交媒体产生不利影响。由于有关 SNS 对政策制定的个人层面影响的系统性研究并不多见,本文探讨了 SNS 对政策相关信息的使用,进而对个人政治能力的影响。本文基于对德国、意大利和挪威中央部委官僚机构的调查数据,进行了调节中介分析,不仅考虑了立法起草过程中使用的信息量,还考虑了信息来源的多变性和集中性。结果表明,SNS 与政策官员的信息使用呈正相关,这反过来又提高了他们自我报告的政治能力。然而,当社交媒体压力水平较高而不是较低时,SNS 与信息使用的数量和变化之间的正相关关系就会减弱。结论讨论了对公务员和决策的影响。
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引用次数: 0
COVID-19 memorable messages as internal narratives: stability and change over time COVID-19 作为内部叙述的难忘信息:稳定性和随时间的变化
IF 5.3 3区 管理学 Q1 PUBLIC ADMINISTRATION Pub Date : 2024-07-08 DOI: 10.1007/s11077-024-09538-5
Rob A. DeLeo, Elizabeth A. Shanahan, Kristin Taylor, Nathan Jeschke, Deserai Crow, Thomas A. Birkland, Elizabeth Koebele, Danielle Blanch-Hartigan, Courtney Welton-Mitchell, Sandhya Sangappa, Elizabeth Albright, Honey Minkowitz

A robust body of research using the Narrative Policy Framework (NPF) has explored the effect of external messages on individual affective responses and behavior, typically at a single point in time. Missing from this micro-level analysis is a careful assessment of the ways in which individuals process information, whether their internal cognitions are communicated in narrative structure, and what the durability of any narrative structure is over time. We address this gap by examining (1) the extent to which individuals recall “memorable messages” in narrative form (e.g., the use of characters and morals) and with what content (e.g., who is cast in these character roles) and (2) whether individuals’ narrative form and content change across time. Memorable messages are pieces of information that are remembered for an extended period of time. We draw on data derived from a multi-wave panel survey of residents in six U.S. states (Colorado, Iowa, Louisiana, Massachusetts, Michigan, and Washington) during the first year of the COVID-19 pandemic. Respondents were asked to recall a memorable message, anything they heard or read that has shaped how they think about the risk of COVID-19. We find that participants articulate recalled memorable messages in narrative form about two-thirds of the time, consistent with how the NPF expects homo narrans to make sense of complex information. However, narratives containing morals are articulated less frequently than those using characters alone. Additionally, individuals’ narrative content changes over time to include new information such as new policy solutions (e.g., mask wearing). Notably, recalled messages lose their narrative form over time.

利用叙事政策框架(NPF)进行的大量研究探讨了外部信息对个人情感反应和行为的影响,这些研究通常是在一个时间点上进行的。在这种微观层面的分析中,缺少的是对个体处理信息的方式、他们的内部认知是否通过叙事结构传达以及任何叙事结构随着时间推移的持久性进行仔细评估。为了弥补这一不足,我们研究了(1)个体在多大程度上以叙事形式(如使用人物和道德)回忆起 "难忘信息",以及 "难忘信息 "的内容(如谁扮演了这些人物角色);(2)个体的叙事形式和内容是否会随着时间的推移而改变。记忆性信息是指能够被长时间记忆的信息片段。我们借鉴了 COVID-19 大流行第一年期间对美国六个州(科罗拉多州、爱荷华州、路易斯安那州、马萨诸塞州、密歇根州和华盛顿州)居民进行的多波面板调查数据。受访者被要求回忆一个难忘的信息,即他们听到或读到的任何影响他们对 COVID-19 风险的看法的信息。我们发现,大约有三分之二的受访者会以叙述的形式来表述所回忆起的难忘信息,这与 NPF 期望智人(homo narrans)理解复杂信息的方式是一致的。然而,与只使用人物的叙述方式相比,包含道德的叙述方式表达的频率较低。此外,个体的叙述内容会随着时间的推移而改变,以包含新的信息,如新的政策解决方案(如戴面具)。值得注意的是,随着时间的推移,回忆信息会失去其叙述形式。
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引用次数: 0
Approaches to policy framing: deepening a conversation across perspectives 制定政策的方法:深化跨观点对话
IF 5.3 3区 管理学 Pub Date : 2024-06-16 DOI: 10.1007/s11077-024-09534-9
Jennifer Dodge, Tamara Metze

Since Rein and Schön developed their approach to policy framing analysis in the1990s, a range of approaches to policy framing have emerged to inform our understanding of policy processes. Prior attempts to illuminate the diversity of approaches to framing in public policy have largely “stayed in their lane,” making distinctions in approaches within shared epistemic communities. The aim in this paper is to map different approaches to framing used in policy sciences journals, to articulate what each contributes to the understanding of the policy process, and to provide a heuristic to aid in deciding how to use the diverse approaches in framing analysis and to further the dialogue across different approaches. To develop the heuristic, we manually coded and analyzed 68 articles published between 1997 and 2018 using “frame” or “framing” in their title or abstract from four policy journals: Critical Policy Studies, Journal of European Public Policy, Policy Sciences, and Policy Studies Journal. We identified five approaches, which we label: sensemaking, discourse, contestation, explanatory and institutional. We have found that these approaches do not align with a simple binary between interpretive and positivist but show variation, particularly along the lines of aims, methodology and methods. In the discussion, we suggest that these five approaches raise four key questions that animate framing studies in policy analysis: (1) Do frames influence policies or are policies manifestations of framing? (2) What is the role of frame contestation in policy conflict? (3) How can the study of frames or framing reveal unheard voices? And (4) how do certain frames/framings become dominant? By introducing these questions, we offer a fresh way scholars might discuss frames and framing in the policy sciences across approaches, to highlight the distinct yet complementary ways they illuminate policy processes.

自莱恩和舍恩于 20 世纪 90 年代提出政策框架分析方法以来,一系列政策框架分析方法应运而生,为我们理解政策过程提供了参考。之前为阐明公共政策框架分析方法的多样性所做的尝试在很大程度上是 "固步自封",在共同的认识论社区内对各种方法进行区分。本文旨在绘制政策科学期刊中使用的不同框架方法图,阐明每种方法对理解政策过程的贡献,并提供一种启发式方法,以帮助决定如何在框架分析中使用不同的方法,并促进不同方法之间的对话。为了开发启发式方法,我们对 1997 年至 2018 年间发表的 68 篇文章进行了人工编码和分析,这些文章的标题或摘要中使用了 "框架 "或 "构架",文章来自四种政策期刊:批判性政策研究》、《欧洲公共政策期刊》、《政策科学》和《政策研究期刊》。我们确定了五种方法,并将其标记为:感性、话语、争议、解释和制度。我们发现,这些方法并不符合解释学和实证主义之间的简单二元对立,而是表现出差异,尤其是在目标、方法论和方法方面。在讨论中,我们认为这五种方法提出了四个关键问题,这些问题激发了政策分析中的框架研究:(1) 框架是否影响政策,或者政策是否是框架的表现形式? (2) 框架争论在政策冲突中的作用是什么?(3) 框架或框架研究如何揭示未被听到的声音?(4) 某些框架如何成为主导?通过引入这些问题,我们为学者们提供了一种讨论政策科学中框架和构架的跨方法的全新途径,以突出它们阐明政策过程的独特而又互补的方式。
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引用次数: 0
The pursuit of welfare efficiency: when institutional structures turn ‘less’ into ‘more’ 追求福利效率:当制度结构变 "少 "为 "多
IF 5.3 3区 管理学 Pub Date : 2024-05-23 DOI: 10.1007/s11077-024-09535-8
Christina Steinbacher

Addressing current socio-economic crises strains public budgets and may threaten fiscal sustainability. Particularly in the welfare sector, where high expenditures meet poor controllability, efficient resource usage is essential to ensure future governments’ capability to act while alleviating current problems. Consequently, this paper asks: why are some countries more efficient in translating social expenditure into welfare outcomes? To answer this question, it is argued that efficiency is a matter of institutional structures and their vertical policy-process integration (VPI): efficiency depends on institutional structures’ capability to (1) ensure policymakers’ responsibility and to (2) provide coordinated feedback, thus pushing for considerate and informed resource use. Analysing the effect of VPI on the relationship between welfare efforts and social outcomes in 21 OECD countries over three decades, the results show that VPI can not only turn ‘less’ into ‘more’, but it also compensates for performance losses in the face of spending cuts.

应对当前的社会经济危机使公共预算捉襟见肘,并可能威胁到财政的可持续性。特别是在福利领域,高支出与低可控性相交织,有效利用资源对于确保未来政府有能力在缓解当前问题的同时采取行动至关重要。因此,本文提出了这样一个问题:为什么有些国家在将社会支出转化为福利成果方面效率更高?为了回答这个问题,本文认为,效率是一个制度结构及其纵向政策流程整合(VPI)的问题:效率取决于制度结构是否有能力(1)确保政策制定者的责任,以及(2)提供协调反馈,从而推动深思熟虑和知情的资源使用。通过分析纵向政策流程整合对 21 个经合组织国家三十年来福利工作与社会成果之间关系的影响,结果表明纵向政策流程整合不仅可以化 "少 "为 "多",而且还能弥补削减开支带来的绩效损失。
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引用次数: 0
Bureaucratic biases in trust of expert policy advice: a randomized controlled experiment based on Chinese think tank reports 专家政策建议信任中的官僚偏见:基于中国智库报告的随机对照实验
IF 5.3 3区 管理学 Pub Date : 2024-05-12 DOI: 10.1007/s11077-024-09533-w
Jingjing Zeng, Guihua Huang
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引用次数: 0
Climate fatalism, partisan cues, and support for the Inflation Reduction Act 气候宿命论、党派线索以及对《通货膨胀削减法》的支持
IF 5.3 3区 管理学 Pub Date : 2024-05-10 DOI: 10.1007/s11077-024-09532-x
Melissa K. Merry, Rodger A. Payne

The United States faces multiple political challenges to achieving the rapid cuts in carbon emissions called for by the Intergovernmental Panel on Climate Change. Among these are the long-standing issue of partisan polarization and the newly emerging problem of climate doom and defeatism. These challenges are not only barriers to agenda-setting and enactment, but can also threaten the durability of policies over time. This study uses a survey experiment from a nationally representative sample (n = 1760) to examine the impact of partisan cues and fatalistic rhetoric on support for the climate provisions of the Inflation Reduction Act. We find that Republicans and Independents exposed to Democratic Party cues expressed less support for the IRA. We also find that Independents respondents exposed to a fatalistic message had reduced support for the IRA. These findings underscore the importance of framing in the post-enactment period and suggest that the IRA may be vulnerable to retrenchment or reversal.

美国在实现政府间气候变化专门委员会(Intergovernmental Panel on Climate Change)所呼吁的快速削减碳排放量方面面临着多重政治挑战。其中包括长期存在的党派两极分化问题,以及新出现的气候末日和失败主义问题。这些挑战不仅阻碍了议程的制定和颁布,而且还会威胁到政策的长期持久性。本研究利用一项具有全国代表性的样本调查实验(n = 1760),考察了党派线索和宿命论言论对《通货膨胀削减法案》气候条款支持率的影响。我们发现,受到民主党暗示的共和党人和独立人士对《减税法案》的支持率较低。我们还发现,受到宿命论信息影响的独立受访者对《减税法案》的支持率也有所下降。这些发现强调了《减税法案》颁布后的框架设计的重要性,并表明《减税法案》可能容易受到削弱或逆转。
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引用次数: 0
The soft underbelly of complexity science adoption in policymaking: towards addressing frequently overlooked non-technical challenges 决策中采用复杂性科学的软肋:努力应对经常被忽视的非技术挑战
IF 5.3 3区 管理学 Pub Date : 2024-04-29 DOI: 10.1007/s11077-024-09531-y
Darren Nel, Araz Taeihagh

The deepening integration of social-technical systems creates immensely complex environments, creating increasingly uncertain and unpredictable circumstances. Given this context, policymakers have been encouraged to draw on complexity science-informed approaches in policymaking to help grapple with and manage the mounting complexity of the world. For nearly eighty years, complexity-informed approaches have been promising to change how our complex systems are understood and managed, ultimately assisting in better policymaking. Despite the potential of complexity science, in practice, its use often remains limited to a few specialised domains and has not become part and parcel of the mainstream policy debate. To understand why this might be the case, we question why complexity science remains nascent and not integrated into the core of policymaking. Specifically, we ask what the non-technical challenges and barriers are preventing the adoption of complexity science into policymaking. To address this question, we conducted an extensive literature review. We collected the scattered fragments of text that discussed the non-technical challenges related to the use of complexity science in policymaking and stitched these fragments into a structured framework by synthesising our findings. Our framework consists of three thematic groupings of the non-technical challenges: (a) management, cost, and adoption challenges; (b) limited trust, communication, and acceptance; and (c) ethical barriers. For each broad challenge identified, we propose a mitigation strategy to facilitate the adoption of complexity science into policymaking. We conclude with a call for action to integrate complexity science into policymaking further.

社会-技术系统的不断深化整合创造了极其复杂的环境,造成了越来越不确定和不可预测的情况。在这种情况下,人们鼓励决策者在制定政策时借鉴以复杂性科学为依据的方法,以帮助应对和管理日益复杂的世界。近八十年来,以复杂性为依据的方法一直有望改变人们对复杂系统的理解和管理方式,最终帮助人们做出更好的决策。尽管复杂性科学潜力巨大,但在实践中,其应用往往局限于少数专业领域,并未成为主流政策辩论的一部分。为了了解为什么会出现这种情况,我们提出了一个问题:为什么复杂性科学仍处于萌芽状态,没有融入决策的核心?具体来说,我们要问的是,有哪些非技术性挑战和障碍阻碍了将复杂性科学纳入决策。为了解决这个问题,我们进行了广泛的文献综述。我们收集了零散的、讨论与在决策中使用复杂性科学有关的非技术性挑战的文本片段,并通过综合我们的发现将这些片段拼接成一个结构化的框架。我们的框架包括三个非技术性挑战的专题分组:(a) 管理、成本和采用挑战;(b) 有限的信任、沟通和接受度;(c) 道德障碍。针对确定的每项广泛挑战,我们都提出了一项缓解战略,以促进在决策中采用复杂性科学。最后,我们呼吁采取行动,进一步将复杂性科学纳入决策。
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引用次数: 0
Wildfire risk and insurance: research directions for policy scientists 野火风险与保险:政策科学家的研究方向
IF 5.3 3区 管理学 Pub Date : 2024-04-29 DOI: 10.1007/s11077-024-09528-7
Matthew R. Auer

Catastrophic wildfire is an increasingly familiar phenomenon on multiple continents. In the United States, concerns about uncontrolled, destructive wildfire have prompted some major insurance carriers to cease writing new policies or to non-renew existing policies. These trends affect not only policyholders, but also, vulnerable communities that already face multiple obstacles to securing property or renters insurance. This study reviews the social and behavioral sciences literatures on wildfire risk in the United States and insurance protection by homeowners. Three categories of research emerge from the review, namely, homeowner as rational actor, wildfire governance and risk management, and wildfire and social equity. There is abundant scholarship on determinants of homeowner decisions to manage wildfire risk by self-protecting or by purchasing insurance, but comparatively little research on the policy implications of shrinking markets for insurance. Policy research on the needs of underinsured and uninsured populations is also relatively undeveloped. Overlaying Lasswell’s social process framework on the three dominant research themes, we find not only divergent research questions, models, and methods, but also, important differences in which stakeholders and stakeholder values are considered. There are opportunities for the different literatures to learn from one another, but also, to sharpen their focus on insurance as a scarce and uncertain resource amid climate change and as property development continues to expand in wildfire-prone areas.

灾难性野火是各大洲越来越常见的现象。在美国,对失控的破坏性野火的担忧已促使一些主要保险公司停止承保新的保单或不再续保现有保单。这些趋势不仅影响到投保人,也影响到那些在获得财产保险或租房保险方面已经面临多重障碍的脆弱社区。本研究回顾了有关美国野火风险和房主保险保护的社会和行为科学文献。综述中提出了三类研究,即作为理性行为者的房主、野火治理与风险管理以及野火与社会公平。关于房主决定通过自我保护或购买保险来管理野火风险的决定因素有大量的学术研究,但关于保险市场萎缩的政策影响的研究相对较少。有关投保不足和未投保人群需求的政策研究也相对较少。将拉斯韦尔的社会过程框架与这三个主要研究主题相叠加,我们不仅发现了不同的研究问题、模式和方法,还发现了在考虑利益相关者和利益相关者价值方面的重要差异。不同的文献不仅有机会相互学习,而且还能在气候变化以及野火易发地区房地产开发不断扩大的情况下,更加关注保险这一稀缺且不确定的资源。
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引用次数: 0
There, across the border – political scientists and their boundary-crossing work 在那里,跨越边界--政治学家及其跨界工作
IF 5.3 3区 管理学 Pub Date : 2024-04-24 DOI: 10.1007/s11077-024-09530-z
Pierre Squevin, Valérie Pattyn, Jens Jungblut, Sonja Blum

Scholars may be diversely engaged in boundary-crossing work, either staying more confined in academic settings, or reaching out to the policy world. Despite growing theoretical attention, there is little empirical knowledge on the extent to which scholars indeed engage in boundary-crossing activities, and the conditions that foster or jeopardize this. We use original survey data from European political scientists to investigate how frequently they ‘travel’ to the policy world, what patterns of engagement are visible, and how these are determined. The article introduces a typology capturing different boundary-crossing profiles and shows that political scientists are rather frequent travelers across the border between academia and the policy world. Yet, individual characteristics matter. Having (had) a position outside of academia has an especially strong effect on the likelihood of boundary-crossing. Our results also reveal that not every scholar has the same chance to be involved, depending on gender or seniority.

学者们可能以不同的方式参与跨界工作,或更多地局限于学术环境,或将触角伸向政策领域。尽管理论界的关注与日俱增,但对于学者在多大程度上确实参与了跨界活动,以及促进或阻碍跨界活动的条件,却鲜有实证知识。我们利用欧洲政治科学家的原始调查数据,调查了他们 "旅行 "到政策世界的频率、可见的参与模式以及这些模式是如何决定的。文章介绍了一种捕捉不同跨界特征的类型学,并表明政治科学家是学术界与政策界之间相当频繁的跨界旅行者。然而,个人特征也很重要。拥有(曾经拥有)学术界以外的职位对跨界的可能性有特别大的影响。我们的研究结果还显示,并非每位学者都有同样的机会参与其中,这取决于性别或资历。
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引用次数: 0
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