Myten om centralisering – Om sjukvården som ett polycentriskt system

Abstract

Sammanfattning:
Syftet med denna rapport är att analysera sjukvården utifrån ett polycentriskt perspektiv, i jämförelse med ett monocentriskt, mer centraliserat, samt att diskutera hur ökade polycentriska inslag skulle kunna utveckla svensk vård och omsorg. Författarnas hypotes är att vård- och omsorgssystem som utmärks av en mångfald av finansiärer och utförare, med stora inslag av valfrihet och spritt ansvar, klarar vårduppdraget lika bra eller bättre än mer centraliserade och helt skattefinansierade system.

Karlson, N. & Lundbäck, M. (2021). Myten om centralisering – Om sjukvården som ett polycentriskt system. (Ratioakademiens sjukvårdsprojekt, rapport nr. 1) Stockholm: Ratio.

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Insider activism—where bureaucrats use discretionary power to advance own ideological goals—has significant implications for regulatory stability and property rights security. Using the Swedish forestry industry as a case study, the purpose of this study is to investigate if insider activism affects the Swedish forestry sector and how such possible regulatory uncertainty influences economic decision-making. Assembled survey data suggest that forest owners perceive regulatory enforcement as unpredictable, leading to defensive actions such as premature harvesting to preempt restrictive future regulations. To explain these patterns, we apply public choice theory and a game-theoretic approach, demonstrating how bureaucratic drift, regulatory ratcheting, and time-inconsistency problems contribute to persistent distortions in forestry policies. Policy wise, the findings emphasize the need for judicial review, regulatory impact assessments, and clearer legislative mandates to reduce enforcement uncertainty and improve institutional trust. This research advances discussions on bureaucratic incentives, regulatory capture, and legal certainty in environmental policy.

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The book is open source and can be downloaded through the link below.

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Karlson, N., Herold, T. & Dalbard, K.

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Published in

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Abstract

This paper investigates whether an increased use and reinterpretation of what has been called “fair competition” has occurred at the expense of “free competition” among the central institutions of the European Union. We are also interested in assessing how frequently these terms have been used by the various EU institutions over time.

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Myten om centralisering – Om sjukvården som ett polycentriskt system

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