German centralization strategy during COVID-19: Continuing or interrupting a trend?

Ines Marina Niehaus, Andreas Lehr, André Kaiser, Helena Sophie Müller and Ludwig Kuntz

Health Policy, 2024, vol. 150, issue C

Abstract: In response to the COVID-19 pandemic, many countries applied centralization strategies to the distribution of power between national government and regional/local governments over responsibility for regulatory tasks. As a result, health-policy decision-making competences were shifted from the regional level to the national level (vertical shift of decision-making competences). This centralization trend for the purpose of infection control is evident in Germany. We conducted a quantitative and qualitative analysis of health-policy regulatory measures (March 2018 to March 2020) in order to investigate whether the vertical shift in decision-making competences was already a trend in Germany before the COVID-19 pandemic and beyond infection control. Our results show that the centralization strategy observed during COVID-19 does not continue a trend. Before the COVID-19 pandemic, what was most important was the distribution of power at national level between government and non-government institutions (horizontal allocation of decision-making competences). This long-term trend strengthens the decision-making competences of government institutions and weakens non-government institutions.

Keywords: Health policy; Germany; Government; Federalism; Decision-making; Health Care Reform; Decentralization; Regulation (search for similar items in EconPapers)
Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:150:y:2024:i:c:s0168851024001878

DOI: 10.1016/j.healthpol.2024.105177

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