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Centralizing and decentralizing governance in the COVID-19 pandemic: The politics of credit and blame.
Greer, Scott L; Rozenblum, Sarah; Falkenbach, Michelle; Löblová, Olga; Jarman, Holly; Williams, Noah; Wismar, Matthias.
  • Greer SL; Department of Health Management and Policy, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, Michigan 48109, United States of America; European Observatory on Health Systems and Policies, Eurostation, Place Victor Horta/Victor Hortaplein, 40/30, 1060 Brussels, Belg
  • Rozenblum S; Department of Health Management and Policy, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, Michigan 48109, United States of America.
  • Falkenbach M; Department of Health Management and Policy, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, Michigan 48109, United States of America; Department of Public and Ecosystem Health, Cornell University, Ithaca NY 18453, United States of America.
  • Löblová O; Department of Sociology, University of Cambridge, Floor 2, 16 Mill Lane, Cambridge CB2 1SB, United Kingdom.
  • Jarman H; Department of Health Management and Policy, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, Michigan 48109, United States of America.
  • Williams N; Department of Health Management and Policy, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, Michigan 48109, United States of America.
  • Wismar M; European Observatory on Health Systems and Policies, Eurostation, Place Victor Horta/Victor Hortaplein, 40/30, 1060 Brussels, Belgium.
Health Policy ; 126(5): 408-417, 2022 05.
Article in English | MEDLINE | ID: covidwho-1734409
ABSTRACT
COVID-19 led to significant and dynamic shifts in power relations within and between governments, teaching us how governments make health policies and how health crises affect government. We focus on centralization and decentralization within and between governments within government, meaning the extent to which the head of government controls policy; and between governments, meaning the extent to which the central government pre-empts or controls local and regional government. Political science literature suggests that shifting patterns of centralization and decentralization can be explained by leading politicians' efforts to gain credit for popular actions and outcomes and deflect blame for unpopular ones. We test this hypothesis in two ways by coding the Health Systems Response Monitor's data on government responses, and through case studies of the governance of COVID-19 in Austria, Czechia and France. We find that credit and blame do substantially explain the timing and direction of changes in centralization and decentralization. In the first wave, spring 2020, heads of government centralized and raised their profile in order to gain credit for decisive action, but they subsequently tried to decentralize in order to avoid blame for repeated restrictions on life or surges of infection. These findings should shape advice on governance for pandemic response.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study Limits: Humans Language: English Journal: Health Policy Journal subject: Health Services Research / Public Health Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study Limits: Humans Language: English Journal: Health Policy Journal subject: Health Services Research / Public Health Year: 2022 Document Type: Article