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1 – 4 of 4Erik Bækkeskov and Peter Triantafillou
Healthcare provision in Denmark reflects some of the key principles of the welfare state. By securing relatively easy and equal access for all Danish residents regardless of…
Abstract
Healthcare provision in Denmark reflects some of the key principles of the welfare state. By securing relatively easy and equal access for all Danish residents regardless of income via general tax financing, the Danish healthcare system has strong ethical merits. All residents are entitled to comprehensive healthcare services. The Danish healthcare system is also relatively efficient. Total healthcare expenditures – including public and private – amount to 10% of GDP, above the OECD 8.8% average but well below the costs in the other Nordic countries, Germany, Switzerland and the United Stated. Notwithstanding its merits, healthcare in Denmark shares key predicaments with other OECD countries, primarily how to improve health outcomes while containing care expenditures. All of the OECD countries aim to improve population life expectancy and health quality. Yet their ageing and increasingly obese populations are exacerbating the demands on their respective healthcare systems. This chapter examines changes in how Denmark has managed these challenges. The main argument is that the healthcare system performance on managing health outcomes and costs improved remarkably from the 1990s to the early 2020s, although outcome inequalities remain. Notable changes in the system were targeted innovations in treatment procedures and expansion of municipal rehabilitation and preventive efforts, along with strict budget controls.
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Erik Baekkeskov and Olivier Rubin
The purpose of this paper is to show that 2009 H1N1 “swine” influenza pandemic vaccination policies deviated from predictions established in the theory of political survival, and…
Abstract
Purpose
The purpose of this paper is to show that 2009 H1N1 “swine” influenza pandemic vaccination policies deviated from predictions established in the theory of political survival, and to propose that pandemic response deviated because it was ruled by bureaucratized experts rather than by elected politicians.
Design/methodology/approach
Focussing on the 2009 H1N1 pandemic, the paper employs descriptive statistical analysis of vaccination policies in nine western democracies. To probe the plausibility of the novel explanation, it uses quantitative and qualitative content analyses of media attention and coverage in two deviant cases, the USA and Denmark.
Findings
Theories linking political survival to disaster responses find little empirical support in the substantial cross-country variations of vaccination responses during the 2009 H1N1 pandemic. Rather than following a political logic, the case studies of media coverage in the USA and Denmark demonstrate that the response was bureaucratized in the public health agencies (CDC and DMHA, respectively). Hence, while natural disaster responses appear to follow a political logic, the response to pandemics appears to be more strongly instituted in the hands of bureaucratic experts.
Research limitations/implications
There is an added value of encompassing bureaucratic dynamics in political theories of disaster response; bureaucratized expertise proved to constitute a strong plausible explanation of the 2009 pandemic vaccination response.
Practical implications
Pandemic preparedness and response depends critically on understanding the lessons of the 2009 H1N1 pandemic; a key lesson supported by this paper is that expert-based agencies rather than political leaders are the pivotal actors.
Originality/value
This paper is the first to pinpoint the limitations of political survival theories of disaster responses with respect to the 2009 pandemic. Further, it is among the few to analyze the causes of variations in cross-country pandemic vaccination policies during the 2009 H1N1 pandemic.
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Andreas Hagedorn Krogh, Annika Agger and Peter Triantafillou
In this concluding chapter, the editors provide an overall assessment of contemporary Danish public governance based on the main findings in the preceding chapters of the edited…
Abstract
In this concluding chapter, the editors provide an overall assessment of contemporary Danish public governance based on the main findings in the preceding chapters of the edited volume. Surveying the Danish governance responses to contemporary mega-challenges, the chapter reflects on policy implications and contemplate the future of both research and practice related to public administration, politics and governance in Denmark. The chapter argues that recent public governance reforms have turned the Danish welfare state into a mix of a neo-Weberian state and an enabling state, which deploys its considerable resources to create economic growth for the benefit of the large majority of Danes, to satisfy the needs of citizens and businesses and to develop collaborative solutions to complex problems. While the chapter concludes that this modified version of the well-known universal welfare state is largely apt for meeting the mega-challenges of the twenty-first century, recent reforms seeking to enhance job-seeking incentives for the unemployed and to integrate immigrants have resulted in new forms of marginalisation of weaker societal groups. Moreover, evolving problems such as climate change, an ageing population and digital citizen privacy will require further public governance reforms in the years to come.
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Peter Triantafillou, Andreas Hagedorn Krogh and Annika Agger
In the twenty-first century, societies around the world are facing a wide range of daunting global mega-challenges: poverty, unemployment, income inequality, unequal distribution…
Abstract
In the twenty-first century, societies around the world are facing a wide range of daunting global mega-challenges: poverty, unemployment, income inequality, unequal distribution of political power, ageing populations, uncontrolled migration, segregated urbanisation, increasing greenhouse gas emissions and a massive decrease in biodiversity. In recent years, politicians, journalists and academic observers have singled out the Nordic countries, Denmark in particular, as model societies of trusting and happy people that have handled many of these challenges with remarkable effectiveness. And yet others warn against ‘becoming Denmark,’ painting a picture of a dysfunctional, socialist nightmare with high taxes, low job motivation and a general lack of private initiative. In this introductory chapter, the editors cut through the noise of the international debate and set the scene for the nuanced analyses presented here of contemporary public governance in Demark and its capacity to tackle some of the most pressing problems of our time. Specifically, the chapter discusses various conceptualisations of the Danish welfare state, delineates some of its most important historical and structural traits and outlines the main empirical features of contemporary Danish public governance. Finally, it outlines the structure of the book and briefly introduces each of its subsequent chapters.
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