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Federalism and public health decentralisation in the time of COVID-19

Author

Listed:
  • Pietrangelo de Biase
  • Sean Dougherty

Abstract

The Coronavirus pandemic has put extreme pressure on public health services, often delivered at the local and regional levels of government. The paper focuses on how countries made changes to the configuration of federalism during the first wave of the pandemic. These changes typically have involved the centralisation and decentralisation of certain health-related activities, as well as the creation of new coordination and funding mechanisms. Specific tools that have been used include an enhanced role of the executive branch (“executive federalism”), the use of centres of government for vertical coordination, as well as the introduction of unique state-of-emergency laws. New horizontal coordination arrangements have also emerged with the more decentralised approaches. The strengths, weaknesses and implementation risks of various approaches are analysed using country examples.

Suggested Citation

  • Pietrangelo de Biase & Sean Dougherty, 2021. "Federalism and public health decentralisation in the time of COVID-19," OECD Working Papers on Fiscal Federalism 33, OECD Publishing.
    • Handle: RePEc:oec:ctpaab:33-en
    DOI: 10.1787/b78ec8bb-en
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    Cited by:

    1. Beatriz González López-Valcárcel & Guillem López-Casanovas, 2022. "Economic factors behind the pandemic deaths. A regional perspective," Working Papers. Collection A: Public economics, governance and decentralization 2213, Universidade de Vigo, GEN - Governance and Economics research Network.
    2. Gerson Javier Pérez-Valbuena & Paula Barrios, 2022. "Subnational fiscal accounts under pressure: the effects of COVID-19 in a developing country," Documentos de trabajo sobre Economía Regional y Urbana 306, Banco de la Republica de Colombia.
    3. Gonçalo Santinha & Alexandre Fernandes & Rafaela Oliveira & Nelson Pacheco Rocha, 2023. "Designing a Health Strategy at Local Level: A Conceptual Framework for Local Governments," IJERPH, MDPI, vol. 20(13), pages 1-22, June.
    4. Przemysław Śleszyński & Paulina Legutko-Kobus & Mark Rosenberg & Viktoriya Pantyley & Maciej J. Nowak, 2022. "Assessing Urban Policies in a COVID-19 World," IJERPH, MDPI, vol. 19(9), pages 1-19, April.
    5. Sean Dougherty & Pietrangelo Biase, 2021. "Who absorbs the shock? An analysis of the fiscal impact of the COVID-19 crisis on different levels of government," International Economics and Economic Policy, Springer, vol. 18(3), pages 517-540, July.
    6. Perna, Roberta & Cruz-Martínez, Gibrán & Moreno Fuentes, Francisco Javier, 2022. "Patient mobility within national borders. Drivers and politics of cross-border healthcare agreements in the Spanish decentralized system," Health Policy, Elsevier, vol. 126(11), pages 1187-1193.

    More about this item

    Keywords

    Coronavirus; fiscal federalism; intergovernmental coordination; public health services; subnational governments;
    All these keywords.

    JEL classification:

    • H11 - Public Economics - - Structure and Scope of Government - - - Structure and Scope of Government
    • H70 - Public Economics - - State and Local Government; Intergovernmental Relations - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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