The persistence of cliques in the post-communist state. The case of deniability in drug reimbursement policy in Poland
Bibliographic Data
| ID | 5609738 |
|---|---|
| Authors | Piotr Ozieranski (0000-0002-2023-3288, Department of Social and Policy Sciences University of Bath), Lawrence King (0000-0002-5714-406X, Department of Sociology University of Cambridge, corresponding author) |
| Year | 2016 |
| Volume | 67 |
| Issue | 2 |
| Pages | 216-241 |
| Publication date | 2016-06-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | British Journal of Sociology (JOURNAL) |
| Journal identifiers | ISSN: 0007-1315 • E-ISSN: 1468-4446 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/1468-4446.12193 |
| PMID | 27206533 |
| OpenAlex | W2401823228 |
| Language | EN |
| Citations received | 3 |
| References cited | 22 |
This article explores a key question in political sociology: Can post-communist policy-making be described with classical theories of the Western state or do we need a theory of the specificity of the post-communist state? In so doing, we consider Janine Wedel's clique theory, concerned with informal social actors and processes in post-communist transition. We conducted a case study of drug reimbursement policy in Poland, using 109 stakeholder interviews, official documents and media coverage. Drawing on 'sensitizing concepts' from Wedel's theory, especially the notion of 'deniability', we developed an explanation of why Poland's reimbursement policy combined suboptimal outcomes, procedural irregularities with limited accountability of key stakeholders. We argue that deniability was created through four main mechanisms: (1) blurred boundaries between different types of state authority allowing for the dispersion of blame for controversial policy decisions; (2) bridging different sectors by 'institutional nomads', who often escaped existing conflicts of interest regulations; (3) institutional nomads' 'flexible' methods of influence premised on managing roles and representations; and (4) coordination of resources and influence by elite cliques monopolizing exclusive policy expertise. Overall, the greatest power over drug reimbursement was often associated with lowest accountability. We suggest, therefore, that the clique theory can be generalized from its home domain of explanation in foreign aid and privatizations to more technologically advanced policies in Poland and other post-communist countries. This conclusion is not identical, however, with arguing the uniqueness of the post-communist state. Rather, we show potential for using Wedel's account to analyse policy-making in Western democracies and indicate scope for its possible integration with the classical theories of the state
Accountability · Communism · Communist state · Health care · Law and economics · Political economy · Political science · Politics · Reimbursement · Sociology · Electoral Systems and Political Participation · Law · Political Influence and Corporate Strategies · Public Administration · Social Policy and Reform Studies
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Rebuilding Leviathan
Bringing the State Back In
The State in Capitalist Society
The Blame Game
The Retreat of the State
Rebellious Civil Society
What Was Socialism, and What Comes Next
Drug Evaluation and the Permissive Principle
Collision and Collusion
Recombinant Property in East European Capitalism
Neopluralism
Bourdieu recontextualized
Desperately seeking cancer drugs
| Unique citing works | 3 |
|---|---|
| Citations per year | 0,38 |
| Citation span | 2018 - 2025 (8) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 3 |