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Healthcare governance, professions and populism: Is there a relationship? An explorative comparison of five European countries

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  • Pavolini, Emmanuele
  • Kuhlmann, Ellen
  • Agartan, Tuba I.
  • Burau, Viola
  • Mannion, Russell
  • Speed, Ewen

Abstract

A new wave of support for populist parties and movements represents a serious threat to universal healthcare coverage in traditional liberal democracies and beyond. This article aims to contribute empirical material on the relationships between healthcare governance, professions and populism. It applies an explanatory cross-country comparative approach and uses mixed methods, including micro-level data garnered from international comparative databases and documents. Denmark, England, Germany, Italy and Turkey have been selected for comparison, reflecting different types of healthcare systems and populist movements. The results reveal variety in the ways populist discourses impact in healthcare. Abundant economic resources, network-based governance, high levels of trust in healthcare providers and doctors participating as insiders in the policy process seem to work as a bulwark against populist attacks on healthcare and professional expertise. On the other hand, poorly resourced NHS systems with doctors as outsiders in the policy process and major NPM reforms together with low to medium levels of trust in healthcare providers may be fertile ground for populist discourse to flourish. Our explanatory data provide hints of correlations, which may inform further studies to investigate causality. Yet the research highlights that healthcare governance and professions matter, and brings into view capacity for counteracting populist attacks on universal healthcare and professional knowledge.

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  • Pavolini, Emmanuele & Kuhlmann, Ellen & Agartan, Tuba I. & Burau, Viola & Mannion, Russell & Speed, Ewen, 2018. "Healthcare governance, professions and populism: Is there a relationship? An explorative comparison of five European countries," Health Policy, Elsevier, vol. 122(10), pages 1140-1148.
    • Handle: RePEc:eee:hepoli:v:122:y:2018:i:10:p:1140-1148
    DOI: 10.1016/j.healthpol.2018.08.020
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    References listed on IDEAS

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    1. Mackenbach, Johan P. & McKee, Martin, 2015. "Government, politics and health policy: A quantitative analysis of 30 European countries," Health Policy, Elsevier, vol. 119(10), pages 1298-1308.
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    3. Tenbensel, Tim & Burau, Viola, 2017. "Contrasting approaches to primary care performance governance in Denmark and New Zealand," Health Policy, Elsevier, vol. 121(8), pages 853-861.
    4. Johanna Birkhäuer & Jens Gaab & Joe Kossowsky & Sebastian Hasler & Peter Krummenacher & Christoph Werner & Heike Gerger, 2017. "Trust in the health care professional and health outcome: A meta-analysis," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-13, February.
    5. Agartan, Tuba I., 2015. "Health workforce policy and Turkey's health care reform," Health Policy, Elsevier, vol. 119(12), pages 1621-1626.
    6. Wendt, Claus & Agartan, Tuba I. & Kaminska, Monika Ewa, 2013. "Social health insurance without corporate actors: Changes in self-regulation in Germany, Poland and Turkey," Social Science & Medicine, Elsevier, vol. 86(C), pages 88-95.
    7. Davis, Courtney, 2015. "Drugs, cancer and end-of-life care: A case study of pharmaceuticalization?," Social Science & Medicine, Elsevier, vol. 131(C), pages 207-214.
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    1. Vulpe, Simona - Nicoleta & Rughinis, Cosima, 2021. "Social amplification of risk and “probable vaccine damage”:A typology of vaccination beliefs in 28 European countries," MPRA Paper 105949, University Library of Munich, Germany.
    2. Mauro, Marianna & Giancotti, Monica, 2021. "Italian responses to the COVID-19 emergency: Overthrowing 30 years of health reforms?," Health Policy, Elsevier, vol. 125(4), pages 548-552.

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