Federalism and Decentralization in German Health and Social Care Policy

Abstract

In Germany, regional and local jurisdictions are the place where in many policy fields administrative resources are located, and where the relevant organizational actors – both public and private – implement social policies (Banting and Corbett 2002). Decision-making about benefits and beneficiaries as well as social policy financing, however, tend to be highly centralized. Subnational ( Länder -) governments have strong participation rights in such decisions, yet there are few areas in which individual Bundesländer can shape institutions or policies unilaterally or autonomously (Ziblatt 2002: 628 ff.).There is, therefore, no clear allocation of authority over the making and implementation of (health) policy across territorial levels (Jordan 2008: 168). Decision-making, control over finances, implementation, and supervision of performance are in different hands. These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.