Exploring Organised Interests in Post-Communist Healthcare

In recent years, political science has made a strong contribution to the comparative analysis of organized interests in political processes. However, the post-communist countries have largely been neglected. To overcome this research gap, we examine the opportunity structures and concrete impact of organized interests on the healthcare policies of three post-communist countries – Hungary, the Czech Republic, and Poland. During democratic consolidation, these countries moved away from their healthcare model based on state ownership towards the establishment of a national insurance authority or a system of private insurers. This shift away from large state-run medical facilities was accompanied by measures to privatize hospitals and transfer services to private providers and decentralized authorities. This paper examines the role of civil society organizations and interest groups in shaping Czech, Hungarian, and Polish healthcare policy. The main part of our analysis is dedicated to the study of the influence of patients’ and medical lobbies on policy outputs. In doing so, we focus on interest group-specific (i.e. diffuse vs. concentrated interests), issue-specific (distributive vs. regulatory policies) as well as socio-economic factors (i.e. degree of economic coordination), which may mediate the influence of organized interests. Based on the “preference realization method” we analyze to what extent organized interests have succeeded bringing important health care legislation in line with their preferences. In keeping with the overarching theme of the panel, we revisit the hypothesis that societal interests remain traditionally weak in post-communist polities (Ágh 1996, Howard 2003, Cox 2012).