Regional decentralisation of health policy in Spain: Social capital does not tell the whole story

West European Politics

Volumn 21, Issue 4, 1998, Pages 180-199

  Rico, Ana ^a   Fraile, Marta ^b   Gonzalez, Pablo ^b  

^a UNIVERSITAT POMPEU FABRA   (Spain)

^b Juan March Institute   (Spain)

Author keywords

[No Author keywords available]

Indexed keywords

DECENTRALIZATION; HEALTH POLICY; INSTITUTIONAL FRAMEWORK;

SPAIN;

EID: 0032442698     PISSN: 01402382     EISSN: None     Source Type: Journal    
DOI: 10.1080/01402389808425277     Document Type: Article

References (17)

1. The main contributions by the authors used here are: R. Putnam, R. Leonardi, and R. Nannetti, Making Democracy Work (Princeton UP 1993); and idem, idem, idem and S. Pavoncello, 'The dynamics of institutional success: the case of Italian regional government', American Political Science Review 77/1 (1983) pp.55-74. The complete collection of materials published by the research team on the results of their research on the Italian regions can be found in Putnam et al., Making Democracy Work, p. 207, endnote 1.
2. The main contributions by the authors used here are: R. Putnam, R. Leonardi, and R. Nannetti, Making Democracy Work (Princeton UP 1993); and idem, idem, idem and S. Pavoncello, 'The dynamics of institutional success: the case of Italian regional government', American Political Science Review 77/1 (1983) pp.55-74. The complete collection of materials published by the research team on the results of their research on the Italian regions can be found in Putnam et al., Making Democracy Work, p. 207, endnote 1.
3. The main contributions by the authors used here are: R. Putnam, R. Leonardi, and R. Nannetti, Making Democracy Work (Princeton UP 1993); and idem, idem, idem and S. Pavoncello, 'The dynamics of institutional success: the case of Italian regional government', American Political Science Review 77/1 (1983) pp.55-74. The complete collection of materials published by the research team on the results of their research on the Italian regions can be found in Putnam et al., Making Democracy Work, p. 207, endnote 1.
4. Putnam et al. ibid. p.61.
5. This is true only with respect to the 18 Italian ordinary regions. As is well-known, the Italian Constitution distinguishes between two types of regions: ordinary and special ones. The latter are mainly border regions, characterised by stronger peripheral nationalist feelings. After the Second World War, they achieved a distinctive constitutional status, which explains the earlier transfer of powers as well as some institutional peculiarities. A further curious fact here is that special regions, although initially considered in the first research programme of Putnam et al., are not formally included in the final statistical analysis.
6. See especially the collection of articles in Margaret Levi (ed.) Politics and Society 24/1 (March 1996). Later contributions on this issue are C. Boix and D. Postner, 'Making social capital work', Center for International Affairs Working Paper 96/4 (Cambridge: Harvard UP 1996).
7. See especially the collection of articles in Margaret Levi (ed.) Politics and Society 24/1 (March 1996). Later contributions on this issue are C. Boix and D. Postner, 'Making social capital work', Center for International Affairs Working Paper 96/4 (Cambridge: Harvard UP 1996).
8. See V. Fargion, 'Social assistance and the North-South cleavage in Italy', Southern European Society and Politics 1/3 (Winter 1996) pp. 135-54.
9. Boix and Postner, 'Making social capital work' (note 4).
10. An extended analysis of this question can be found in A. Rico, 'Descentralización y reforma sanitaria en España (1976-1996)', unpublished PhD thesis (Madrid: Inst. Juan March de Estudios e Investigaciones 1997). For a short published summary see A. Rico, P. González and M. Fraile, 'La descentralización sanitaria en España', Hacienda Pública Española (forthcoming).
11. An extended analysis of this question can be found in A. Rico, 'Descentralización y reforma sanitaria en España (1976-1996)', unpublished PhD thesis (Madrid: Inst. Juan March de Estudios e Investigaciones 1997). For a short published summary see A. Rico, P. González and M. Fraile, 'La descentralización sanitaria en España', Hacienda Pública Española (forthcoming).
12. On the issue of regional health care expenditure, see Rico, Descentralización (note 7) Ch. 8. The estimation of regional infrastructures and personnel discussed in the text is taken from J. Puig et al., Análisis de las necesidades, dotaciones y déficits en infraestructuras sanitarias en las Comunidades Autónomas del Estado español (Barcelona: U. Pompeu Fabra 1995).
13. On the issue of regional health care expenditure, see Rico, Descentralización (note 7) Ch. 8. The estimation of regional infrastructures and personnel discussed in the text is taken from J. Puig et al., Análisis de las necesidades, dotaciones y déficits en infraestructuras sanitarias en las Comunidades Autónomas del Estado español (Barcelona: U. Pompeu Fabra 1995).
14. The calculation of health care needs is a complex task. For this reason, two types of needs indices are considered in this article. The first one is taken from A. Rico, 'Aspectos redistributiv os de la financiación sanitaria regional', Las políticas sociales, II Simposio sobre Equidad y Distribución de la Renta y la Riqueza (Madrid: Fundación Argentaria 1996). The second one comes from Puig et al., Análisis (note 8). The main difference between the two lies in the emphasis placed on socio-economic variables. Both indices show an inverse relation with the indices of infrastructures as well as with the average regional levels of public health care expenditure.
15. The calculation of health care needs is a complex task. For this reason, two types of needs indices are considered in this article. The first one is taken from A. Rico, 'Aspectos redistributiv os de la financiación sanitaria regional', Las políticas sociales, II Simposio sobre Equidad y Distribución de la Renta y la Riqueza (Madrid: Fundación Argentaria 1996). The second one comes from Puig et al., Análisis (note 8). The main difference between the two lies in the emphasis placed on socio-economic variables. Both indices show an inverse relation with the indices of infrastructures as well as with the average regional levels of public health care expenditure.
16. The next two sections present brief executive summaries of the research results obtained by the two studies described in the text. Methodological details as well as a full report of the results obtained can be found in Rico, González and Fraile, 'La descentralización sanitaria en España' (note 7).
17. A full report on the Galician case can be found in P. González, 'Estado del Bienestar y redistribución territorial: el caso de Galicia', unpublished BA dissertation (U. de Santiago de Compostela 1997).